Provider Demographics
NPI:1922749795
Name:CARESWAY INC
Entity Type:Organization
Organization Name:CARESWAY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:SUZANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:747-215-6998
Mailing Address - Street 1:800 S CENTRAL AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-4388
Mailing Address - Country:US
Mailing Address - Phone:747-215-6998
Mailing Address - Fax:818-697-9099
Practice Address - Street 1:800 S CENTRAL AVE STE 207
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-4388
Practice Address - Country:US
Practice Address - Phone:747-215-6998
Practice Address - Fax:818-697-9099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-05
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty