Provider Demographics
NPI:1740337104
Name:BORDER HOME CARE OF EL PASO
Entity type:Organization
Organization Name:BORDER HOME CARE OF EL PASO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARLES
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:915-833-5100
Mailing Address - Street 1:414 EXECUTIVE CENTER BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-1066
Mailing Address - Country:US
Mailing Address - Phone:915-833-5100
Mailing Address - Fax:915-833-5101
Practice Address - Street 1:414 EXECUTIVE CENTER BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-1066
Practice Address - Country:US
Practice Address - Phone:915-833-5100
Practice Address - Fax:915-833-5101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008667251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679415Medicare ID - Type UnspecifiedPROVIDER NUMBER