Provider Demographics
NPI:1245847763
Name:PHILLIPSCARE LLC
Entity type:Organization
Organization Name:PHILLIPSCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:KRYSTAL
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, BA
Authorized Official - Phone:914-259-0046
Mailing Address - Street 1:27 TOBINS LN APT 3
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:10928-1961
Mailing Address - Country:US
Mailing Address - Phone:914-259-0046
Mailing Address - Fax:
Practice Address - Street 1:27 TOBINS LN APT 3
Practice Address - Street 2:
Practice Address - City:HIGHLAND FALLS
Practice Address - State:NY
Practice Address - Zip Code:10928-1961
Practice Address - Country:US
Practice Address - Phone:914-259-0046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty