Provider Demographics
NPI:1801048426
Name:AUGUSTINE HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:AUGUSTINE HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSITRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:HOLDEN
Authorized Official - Last Name:MAINGUY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-770-9930
Mailing Address - Street 1:101 BAY ST STE 6
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-2723
Mailing Address - Country:US
Mailing Address - Phone:410-770-9930
Mailing Address - Fax:410-770-9660
Practice Address - Street 1:1316 FENWICK LN FL 15
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3554
Practice Address - Country:US
Practice Address - Phone:301-562-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR987251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD876600200Medicaid