Provider Demographics
NPI:1154631158
Name:TRIOVERSEAS VETERANS HEATHCARE PROVIDER
Entity Type:Organization
Organization Name:TRIOVERSEAS VETERANS HEATHCARE PROVIDER
Other - Org Name:VETHELP MEDICAL SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:NURSE-BILLER
Authorized Official - Prefix:MS
Authorized Official - First Name:RESENA
Authorized Official - Middle Name:MAYUGA
Authorized Official - Last Name:BANTANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:927-650-0014
Mailing Address - Street 1:TRI OVERSEAS VETERANS HEALTH CARE PROVIDER
Mailing Address - Street 2:RM, 504 PHYSICIANS CENTER, DR. R. POTENCIANO
Mailing Address - City:MANDALUYONG CITY
Mailing Address - State:163 EPIFANIO DELOS SANTOS AVE.
Mailing Address - Zip Code:1550
Mailing Address - Country:PH
Mailing Address - Phone:927-650-0014
Mailing Address - Fax:
Practice Address - Street 1:TRI OVERSEAS VETERANS HEALTH CARE PROVIDER
Practice Address - Street 2:RM, 504 PHYSICIANS CENTER, DR. R. POTENCIANO
Practice Address - City:MANDALUYONG CITY
Practice Address - State:163 EPIFANIO DELOS SANTOS AVE.
Practice Address - Zip Code:1550
Practice Address - Country:PH
Practice Address - Phone:927-650-0014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VETHELP MEDICAL SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-10-10
Last Update Date:2010-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility