Provider Demographics
NPI:1861719403
Name:CLASSIC CARE MEDICAL SERVICES
Entity type:Organization
Organization Name:CLASSIC CARE MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADM
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-794-1811
Mailing Address - Street 1:5011 COUNTY ROAD 64
Mailing Address - Street 2:
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583-5323
Mailing Address - Country:US
Mailing Address - Phone:832-794-1811
Mailing Address - Fax:979-549-0830
Practice Address - Street 1:5011 COUNTY ROAD 64
Practice Address - Street 2:
Practice Address - City:ROSHARON
Practice Address - State:TX
Practice Address - Zip Code:77583-5323
Practice Address - Country:US
Practice Address - Phone:832-794-1811
Practice Address - Fax:979-549-0830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health