1780870824 NPI number — SAINT MATTHEW HOME HEALTH CARE LLC

Table of content: (NPI 1780870824)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780870824 NPI number — SAINT MATTHEW HOME HEALTH CARE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAINT MATTHEW HOME HEALTH CARE LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780870824
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/18/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2927 S JACKSON RD
Provider Second Line Business Mailing Address:
SUITE D2, D3
Provider Business Mailing Address City Name:
PHARR
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78577-2595
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-994-8989
Provider Business Mailing Address Fax Number:
956-994-8682

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2927 S JACKSON RD
Provider Second Line Business Practice Location Address:
SUITE D2, D3
Provider Business Practice Location Address City Name:
PHARR
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78577-2595
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-994-8989
Provider Business Practice Location Address Fax Number:
956-994-8682
Provider Enumeration Date:
09/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MELARAGNO
Authorized Official First Name:
PAMELA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
956-994-8989

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 215648101 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: HH487M . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com