MEDICARE: RGV ELDER HEALTH SYSTEMS, 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	008975	TX

General Provider Information

NPI Number	:	1548477748
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RGV ELDER HEALTH SYSTEMS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 1136
Second Line	:
City	:	MISSION
State	:	TX
Zip	:	78573-0018
Country	:	US
Telephone Number	:	956-583-0103
Fax Number	:	956-583-5120

Provider Business Practice Location Address
First Line	:	9500 HWY 107
Second Line	:	SUITE B
City	:	MISSION
State	:	TX
Zip	:	78573-8247
Country	:	US
Telephone Number	:	956-583-0103
Fax Number	:	956-583-5120

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. BENJAMIN MADRIGALES
Credential	:
Telephone Number	:	956-583-0103

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	02/29/2016

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