MEDICARE: ETERNAL CARE SERVICE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1215474242
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ETERNAL CARE SERVICE INC

Provider Business Mailing Address
First Line	:	6821 8TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-5618
Country	:	US
Telephone Number	:	347-517-4090
Fax Number	:	347-517-4016

Provider Business Practice Location Address
First Line	:	6821 8TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-5618
Country	:	US
Telephone Number	:	347-517-4090
Fax Number	:	347-517-4016

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RUB ZHENG
Credential	:
Telephone Number	:	347-517-4090

Provider Enumeration Date	:	01/29/2017
Last Update Date	:	01/29/2017

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