Provider Demographics
NPI:1255325379
Name:SUN CITY HOME CARE, INC.
Entity Type:Organization
Organization Name:SUN CITY HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:KARIM
Authorized Official - Last Name:KAMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-542-0014
Mailing Address - Street 1:1040 BELVIDERE ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-2426
Mailing Address - Country:US
Mailing Address - Phone:915-542-0014
Mailing Address - Fax:915-542-0072
Practice Address - Street 1:1040 BELVIDERE ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-2426
Practice Address - Country:US
Practice Address - Phone:915-542-0014
Practice Address - Fax:915-542-0072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-02
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTXN002026251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX024536701Medicaid
TX677207Medicare ID - Type Unspecified