Provider Demographics
NPI:1679889596
Name:CMS PRIMARY HOME CARE, INC
Entity Type:Organization
Organization Name:CMS PRIMARY HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-424-9897
Mailing Address - Street 1:1524 DOHERTY AVE
Mailing Address - Street 2:STE 5
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-4019
Mailing Address - Country:US
Mailing Address - Phone:956-424-9897
Mailing Address - Fax:
Practice Address - Street 1:1524 DOHERTY AVE
Practice Address - Street 2:STE 5
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-4019
Practice Address - Country:US
Practice Address - Phone:956-424-9897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care