Provider Demographics
NPI:1609366715
Name:MEDI-LAB HOSPICE SERVICES LLC
Entity Type:Organization
Organization Name:MEDI-LAB HOSPICE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:SELENE
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DON
Authorized Official - Phone:956-360-7889
Mailing Address - Street 1:605 S 10TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-4967
Mailing Address - Country:US
Mailing Address - Phone:956-800-5008
Mailing Address - Fax:956-800-5311
Practice Address - Street 1:605 S 10TH ST STE B
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-4967
Practice Address - Country:US
Practice Address - Phone:956-800-5008
Practice Address - Fax:956-800-5311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based