Provider Demographics
NPI:1902916133
Name:CAREPAKS HEALTH SERVICES INCORPORATED
Entity Type:Organization
Organization Name:CAREPAKS HEALTH SERVICES INCORPORATED
Other - Org Name:CAREPAKS MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:C
Authorized Official - Last Name:EBO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:309-454-1000
Mailing Address - Street 1:209 SUSAN DR
Mailing Address - Street 2:
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61761-6188
Mailing Address - Country:US
Mailing Address - Phone:309-454-1000
Mailing Address - Fax:309-454-5000
Practice Address - Street 1:209 SUSAN DR
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761-6188
Practice Address - Country:US
Practice Address - Phone:309-454-1000
Practice Address - Fax:309-454-5000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1009265251E00000X
IL5569640001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02006-N048OtherDEPT. OF LABOR/STAFFING
IL1009265OtherHOME HEALTH CERTIFICATION
IL=========001Medicaid
IL5569640001Medicare NSC