Organization
CORDOVA BAY LLC
Active
Other names
Calvert Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN ELAINE VAHLBERG (CEO)
(405) 329-4545
Entity
Organization
Contact information
Practice address
10207 INDIANA AVE, LUBBOCK, TX 79423-4909
(806) 712-1110
Mailing address
2411 SPRINGER DR, NORMAN, OK 73069-3955
(405) 329-4545
(405) 310-3371
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204464601
—
TX
01
—
677078
MEDICARE PROVIDER NUMBER
TX
Enumeration date
08/20/2008
Last updated
12/18/2019
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