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General NPI Number Information
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NPI Number | 1316486327
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Entity Type | Organization
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Legal Business Name | POLO CARE INC
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Dates
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Enumeration Date | 02/23/2017
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Last Update Date | 02/23/2017
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Provider Practice Location Address
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Address Line | 9050 PARSONS BLVD STE 304
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City | JAMAICA
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State | NY
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Zip | 11432-6052
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Country | US
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Telephone | 718-304-3349
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Fax | 718-206-3504
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Provider Business Mailing Address
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Address Line | PO BOX 678
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City | LYNBROOK
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State | NY
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Zip | 11563-0678
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Country | US
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Telephone | 718-206-3500
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Fax | 718-206-3504
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Authorized Official
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Title or Position | MANAGER
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Name | FAY WILLIAMS
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Credential |
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Telephone | 718-206-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1917L001
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License Number State | NY
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