Provider Demographics
NPI:1346282845
Name:AMERICARE HEALTH SERVICES CORPORATION
Entity Type:Organization
Organization Name:AMERICARE HEALTH SERVICES CORPORATION
Other - Org Name:AMERICARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT-DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:NYLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-821-3355
Mailing Address - Street 1:101 SUN AVE NE
Mailing Address - Street 2:COMPLIANCE DEPARTMENT
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4373
Mailing Address - Country:US
Mailing Address - Phone:505-468-5604
Mailing Address - Fax:505-468-4681
Practice Address - Street 1:101 SUN AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4373
Practice Address - Country:US
Practice Address - Phone:505-468-4678
Practice Address - Fax:505-468-8013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1477332B00000X
GA1477332BN1400X, 332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4581494Medicaid
MD804002800Medicaid
ID806032400Medicaid
NMG4622Medicaid
VA9107282Medicaid
TX011269001Medicaid
MO625357009Medicaid
GA000515699AMedicaid
AZ561101Medicaid
CO48755508Medicaid
KY90003112Medicaid
AL009105980Medicaid
LA1188573Medicaid
IN200251170AMedicaid
NH30761325Medicaid
OH2229565Medicaid
NC7702040Medicaid
TN4581494Medicaid
ID806032400Medicaid
MO625357009Medicaid