Provider Demographics
NPI:1023290913
Name:CARDINAL MEDHEALTH SERVICES, INC.
Entity type:Organization
Organization Name:CARDINAL MEDHEALTH SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:REMEDIOS
Authorized Official - Middle Name:T
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:972-801-2011
Mailing Address - Street 1:4500 PORTRAIT LANE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3848
Mailing Address - Country:US
Mailing Address - Phone:972-801-2011
Mailing Address - Fax:972-801-2019
Practice Address - Street 1:4500 PORTRAIT LANE
Practice Address - Street 2:SUITE 100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3848
Practice Address - Country:US
Practice Address - Phone:972-801-2011
Practice Address - Fax:972-801-2019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X
TX011993251J00000X, 253J00000X, 253Z00000X, 3140N1450X, 385H00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No253J00000XAgenciesFoster Care Agency
No253Z00000XAgenciesIn Home Supportive Care
No3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX197322401Medicaid
45D0974182OtherCLIA
CL1175OtherPTAN
TX011993OtherHCSSA
CL1175OtherPTAN