Provider Demographics
NPI:1356446702
Name:PROMEDE HOME HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:PROMEDE HOME HEALTH SERVICES INC.
Other - Org Name:PROMEDE HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:N
Authorized Official - Last Name:CHIMAOBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-234-7423
Mailing Address - Street 1:12808 W AIRPORT BLVD
Mailing Address - Street 2:STE 220
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-6184
Mailing Address - Country:US
Mailing Address - Phone:713-234-7423
Mailing Address - Fax:713-234-7358
Practice Address - Street 1:12808 W AIRPORT BLVD
Practice Address - Street 2:STE 220
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-6184
Practice Address - Country:US
Practice Address - Phone:713-234-7423
Practice Address - Fax:713-234-7358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX012851251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX010279OtherTEXAS DEPT OF AGING & DISABLED
679644Medicare Oscar/Certification