Provider Demographics
NPI:1689424392
Name:CVC HEALTHCARE INC
Entity Type:Organization
Organization Name:CVC HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CARLSON
Authorized Official - Middle Name:M
Authorized Official - Last Name:IGWACHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-886-8969
Mailing Address - Street 1:6405 COSMOS CT
Mailing Address - Street 2:
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769-9045
Mailing Address - Country:US
Mailing Address - Phone:240-350-2508
Mailing Address - Fax:
Practice Address - Street 1:6405 COSMOS CT
Practice Address - Street 2:
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-9045
Practice Address - Country:US
Practice Address - Phone:240-350-2508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health