Provider Demographics
NPI:1770907818
Name:CMS HOME CARE SUR, LLC.
Entity type:Organization
Organization Name:CMS HOME CARE SUR, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-620-2900
Mailing Address - Street 1:PO BOX 3569
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-3569
Mailing Address - Country:US
Mailing Address - Phone:787-290-1100
Mailing Address - Fax:787-841-4664
Practice Address - Street 1:2004 CARR 506 STE 202 - COTO LAUREL
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00780-2936
Practice Address - Country:US
Practice Address - Phone:787-290-1100
Practice Address - Fax:787-841-4664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-10
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR40-7036OtherMEDICARE