Provider Demographics
NPI:1437594744
Name:ZHON HOME CARE CORPORATION
Entity Type:Organization
Organization Name:ZHON HOME CARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORETTA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-722-5324
Mailing Address - Street 1:PO BOX 3175
Mailing Address - Street 2:
Mailing Address - City:GALLUP
Mailing Address - State:NM
Mailing Address - Zip Code:87305-3175
Mailing Address - Country:US
Mailing Address - Phone:505-722-5324
Mailing Address - Fax:505-722-6977
Practice Address - Street 1:317 BORTOT DR
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-4779
Practice Address - Country:US
Practice Address - Phone:505-722-5324
Practice Address - Fax:505-722-6977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM97975737Medicaid
NM95704591Medicaid