Provider Demographics
NPI:1134247455
Name:MEDCORE HEALTHCARE SERVICES, INC.
Entity type:Organization
Organization Name:MEDCORE HEALTHCARE SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROMANS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-394-2042
Mailing Address - Street 1:3880 GREENHOUSE RD STE 319
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-3335
Mailing Address - Country:US
Mailing Address - Phone:281-394-2042
Mailing Address - Fax:866-395-3908
Practice Address - Street 1:3880 GREENHOUSE RD STE 319
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-3335
Practice Address - Country:US
Practice Address - Phone:832-573-0589
Practice Address - Fax:866-395-3908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX671724Medicare Oscar/Certification