Provider Demographics
NPI:1346618642
Name:PENN PATIENT CARE, LLC
Entity Type:Organization
Organization Name:PENN PATIENT CARE, LLC
Other - Org Name:INFINITO HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:G
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:956-602-0371
Mailing Address - Street 1:1520 E SAN PEDRO ST STE 202
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-5429
Mailing Address - Country:US
Mailing Address - Phone:956-602-0371
Mailing Address - Fax:956-602-0372
Practice Address - Street 1:1520 E SAN PEDRO ST STE 202
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-5429
Practice Address - Country:US
Practice Address - Phone:956-602-0371
Practice Address - Fax:956-602-0372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty