Healthcare Provider Details

I. General information

NPI: 1548034267
Provider Name (Legal Business Name): AUGUSTO HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2023
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 11TH ST SW
PUYALLUP WA
98371-6702
US

IV. Provider business mailing address

1130 11TH ST SW
PUYALLUP WA
98371-6702
US

V. Phone/Fax

Practice location:
  • Phone: 253-315-9184
  • Fax:
Mailing address:
  • Phone: 253-315-9184
  • Fax: 253-322-2383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number StateNULL

VIII. Authorized Official

Name: ROMEO BELOCURA
Title or Position: GOVERNOR
Credential: RN
Phone: 253-315-9184