MEDICARE: LABAUP CORP.

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		NY

General Provider Information

NPI Number	:	1356621742
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LABAUP CORP.

Provider Business Mailing Address
First Line	:	83 S MAIN ST
Second Line	:	SUITE 200
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-5613
Country	:	US
Telephone Number	:	845-548-0912
Fax Number	:

Provider Business Practice Location Address
First Line	:	83 S MAIN ST
Second Line	:	SUITE 200
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-5613
Country	:	US
Telephone Number	:	845-548-0912
Fax Number	:

Authorized Official
Title or Position	:	VP
Name	:	MR. PIERRE LABAZE
Credential	:	RN
Telephone Number	:	845-548-0912

Provider Enumeration Date	:	08/17/2011
Last Update Date	:	08/17/2011

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