Provider Demographics
NPI:1245531839
Name:PATIENT CARE SERVICES INC.
Entity type:Organization
Organization Name:PATIENT CARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICEPRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:HIA
Authorized Official - Phone:787-910-8499
Mailing Address - Street 1:CIUDAD JARDIN III
Mailing Address - Street 2:FLAMBOYAN 197
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953
Mailing Address - Country:US
Mailing Address - Phone:787-910-8499
Mailing Address - Fax:
Practice Address - Street 1:CIUDAD JARDIN III
Practice Address - Street 2:FLAMBOYAN 197
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953
Practice Address - Country:US
Practice Address - Phone:787-910-8499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-12
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR65D57OtherCAGE/NCAGE
PR964742519OtherDUNS