Provider Demographics
NPI:1104202894
Name:SALOSILVER HEALTHCARE LLC
Entity Type:Organization
Organization Name:SALOSILVER HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CASMIR
Authorized Official - Middle Name:I
Authorized Official - Last Name:EGEMASI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-774-4664
Mailing Address - Street 1:12225 GREENVILLE AVENUE
Mailing Address - Street 2:720
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12225 GREENVILLE AVENUE
Practice Address - Street 2:720
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243
Practice Address - Country:US
Practice Address - Phone:214-774-4664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care