Provider Demographics
NPI:1104096080
Name:RG MERIDIAN HEALTH CARE SERVICES
Entity type:Organization
Organization Name:RG MERIDIAN HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RENE
Authorized Official - Middle Name:FERNANDEZ
Authorized Official - Last Name:GAVIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:632-522-4738
Mailing Address - Street 1:2804A ALPHA GRANDVIEW CONDOMINIUM
Mailing Address - Street 2:
Mailing Address - City:MANILA
Mailing Address - State:METROMANILA
Mailing Address - Zip Code:1001
Mailing Address - Country:PH
Mailing Address - Phone:632-522-4738
Mailing Address - Fax:632-522-4738
Practice Address - Street 1:2804A ALPHA GRANDVIEW CONDOMINIUM
Practice Address - Street 2:
Practice Address - City:MANILA
Practice Address - State:METROMANILA
Practice Address - Zip Code:1001
Practice Address - Country:PH
Practice Address - Phone:632-522-4738
Practice Address - Fax:632-522-4738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPHL042238251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health