Provider Demographics
NPI:1942451042
Name:CARDINAL HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:CARDINAL HEALTH CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARY JANE
Authorized Official - Middle Name:BORROMEO
Authorized Official - Last Name:DUREMDES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-712-1510
Mailing Address - Street 1:11233 SHADOW CREEK PARKWAY SUITE 200
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584
Mailing Address - Country:US
Mailing Address - Phone:281-712-1510
Mailing Address - Fax:
Practice Address - Street 1:11233 SHADOW CREEK PKWY STE 200
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7367
Practice Address - Country:US
Practice Address - Phone:281-712-1510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX74-7366OtherMEDICARE CERTIFICATION NUMBER/CCN