Healthcare Provider Details

I. General information

NPI: 1275937997
Provider Name (Legal Business Name): CORE MEDICAL SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2014
Last Update Date: 04/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14A GOFFNEY RD
NEW WAVERLY TX
77358-3828
US

IV. Provider business mailing address

14A GOFFNEY RD
NEW WAVERLY TX
77358-3828
US

V. Phone/Fax

Practice location:
  • Phone: 281-414-8632
  • Fax:
Mailing address:
  • Phone: 281-414-8632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. DEMARIUS D. MCRAE
Title or Position: CEO
Credential:
Phone: 281-414-8632