Provider Demographics
NPI:1316257876
Name:PROMINENT HEALTH CARE SOLUTIONS LLC
Entity type:Organization
Organization Name:PROMINENT HEALTH CARE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALTERNATE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHELIA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-538-3928
Mailing Address - Street 1:821 LONGMEADOW CT
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2844
Mailing Address - Country:US
Mailing Address - Phone:817-538-3928
Mailing Address - Fax:817-561-0392
Practice Address - Street 1:821 LONGMEADOW CT
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2844
Practice Address - Country:US
Practice Address - Phone:817-538-3928
Practice Address - Fax:817-561-0392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health