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General NPI Number Information
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NPI Number | 1215693205
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Entity Type | Organization
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Legal Business Name | PARK AVENUE HOME HEALTH LLC
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Dates
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Enumeration Date | 11/13/2021
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Last Update Date | 02/16/2023
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Provider Practice Location Address
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Address Line | 27045 E UNIVERSITY DR STE 1C
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City | AUBREY
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State | TX
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Zip | 76227-2746
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Country | US
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Telephone | 214-597-9905
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Fax | 214-307-8009
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Provider Business Mailing Address
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Address Line | 27045 E UNIVERSITY DR STE 1C
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City | AUBREY
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State | TX
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Zip | 76227-2746
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Country | US
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Telephone | 214-597-9905
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Fax | 214-307-8009
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CHIDI EMEKA
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Credential | RN
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Telephone | 718-877-8895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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