Provider Demographics
NPI:1619572435
Name:PREVENTATIVE CARE HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:PREVENTATIVE CARE HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ESQUIVEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-837-4812
Mailing Address - Street 1:P.O. BOX 574
Mailing Address - Street 2:
Mailing Address - City:PRESIDIO
Mailing Address - State:TX
Mailing Address - Zip Code:79845
Mailing Address - Country:US
Mailing Address - Phone:432-229-2533
Mailing Address - Fax:432-229-2535
Practice Address - Street 1:1501 N ERMA AVE
Practice Address - Street 2:
Practice Address - City:PRESIDIO
Practice Address - State:TX
Practice Address - Zip Code:79845
Practice Address - Country:US
Practice Address - Phone:432-229-2533
Practice Address - Fax:432-229-2535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy