Provider Demographics
NPI:1649759283
Name:INTERCAPITAL INC.
Entity Type:Organization
Organization Name:INTERCAPITAL INC.
Other - Org Name:OMNIHEALTH HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:PINEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:671-653-1408
Mailing Address - Street 1:761 S MARINE CORPS DR STE A10
Mailing Address - Street 2:
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913-3523
Mailing Address - Country:US
Mailing Address - Phone:671-653-1408
Mailing Address - Fax:671-989-9140
Practice Address - Street 1:761 S MARINE CORPS DR STE A10
Practice Address - Street 2:
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-3523
Practice Address - Country:US
Practice Address - Phone:671-653-1408
Practice Address - Fax:671-989-9140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GU13-201800921-001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health