Provider Demographics
NPI:1467709303
Name:PEGASUS CAREGIVERS INC
Entity Type:Organization
Organization Name:PEGASUS CAREGIVERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:OLUWATOYIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AJIBOYE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:682-422-3436
Mailing Address - Street 1:1218 AUTUMN DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-7940
Mailing Address - Country:US
Mailing Address - Phone:682-422-3436
Mailing Address - Fax:
Practice Address - Street 1:1218 AUTUMN DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-7940
Practice Address - Country:US
Practice Address - Phone:682-422-3436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty