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NPI Code Detail

MEDICARE: PRESTIGE HEALTHCARE SERVICES, INC

MEDICARE: PRESTIGE HEALTHCARE SERVICES, 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
1251E00000XHome Health Agency3235NM

General Provider Information

NPI Number : 1932139730
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRESTIGE HEALTHCARE SERVICES, INC
Provider Business Mailing Address
First Line : 2900 LOUISIANA BLVD NE
Second Line : SUITE A-2
City : ALBUQUERQUE
State : NM
Zip : 87110-3532
Country : US
Telephone Number : 505-880-0400
Fax Number : 505-880-0404
Provider Business Practice Location Address
First Line : 2900 LOUISIANA BLVD NE
Second Line : SUITE A-2
City : ALBUQUERQUE
State : NM
Zip : 87110-3532
Country : US
Telephone Number : 505-880-0400
Fax Number : 505-880-0404
Authorized Official
Title or Position : CEO
Name : MRS. ROSELYN K DUFOUR
Credential : RN, BSN
Telephone Number : 505-880-0400
Provider Enumeration Date : 07/04/2006
Last Update Date : 11/21/2007

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Directions to “PRESTIGE HEALTHCARE SERVICES, INC ” Practice Location

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