Provider Demographics
NPI:1528886975
Name:CASTILLO DONADO CORPORATION
Entity type:Organization
Organization Name:CASTILLO DONADO CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALVARO
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO DONADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-661-7474
Mailing Address - Street 1:1628 BROOKE RD
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-7416
Mailing Address - Country:US
Mailing Address - Phone:703-488-8722
Mailing Address - Fax:
Practice Address - Street 1:207 N BOONE ST # 1350
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-5675
Practice Address - Country:US
Practice Address - Phone:423-661-7474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care