Healthcare Provider Details

I. General information

NPI: 1932246188
Provider Name (Legal Business Name): MERIDIAN HEALTH CARE SVCS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1716 MH DEL PILAR ST. MALATE 2301-A ALPHA GRANDVIEW CONDO
METRO MANILA MANILA
1004
PH

IV. Provider business mailing address

1716 MH DEL PILAR ST. MALATE 2301-A ALPHA GRANDVIEW CONDO
METRO MANILA MANILA
1004
PH

V. Phone/Fax

Practice location:
  • Phone: 632-522-4738
  • Fax: 632-522-4738
Mailing address:
  • Phone: 632-522-4738
  • Fax: 632-522-4738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberPHL009491
License Number StateWI

VIII. Authorized Official

Name: MR. RENE F. GAVIOLA
Title or Position: PRESIDENT
Credential:
Phone: 713-298-6410