Provider Demographics
NPI:1386806099
Name:C & G HOME HEALTH CORP
Entity type:Organization
Organization Name:C & G HOME HEALTH CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IDOLKA
Authorized Official - Middle Name:S
Authorized Official - Last Name:COBIELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-269-8880
Mailing Address - Street 1:5545 SW 8TH ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2274
Mailing Address - Country:US
Mailing Address - Phone:305-269-8880
Mailing Address - Fax:305-269-8889
Practice Address - Street 1:5545 SW 8TH ST
Practice Address - Street 2:SUITE 208
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2274
Practice Address - Country:US
Practice Address - Phone:305-269-8880
Practice Address - Fax:305-269-8889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDING MEDICARE#OtherPENDING MEDICARE#