Organization
CORDOVA BAY LTD
Active
Other names
CALVERT HOME HEALTH CARE LTD
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD E MADISON (VP OF GENERAL PARTNER)
(806) 712-1110
Entity
Organization
Contact information
Practice address
10207 INDIANA AVE, LUBBOCK, TX 79423-4909
(806) 712-1110
Mailing address
10207 INDIANA AVE, LUBBOCK, TX 79423-4909
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
012304
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
679058
MEDICARE PROVIDER NUMBER
TX
Enumeration date
03/17/2009
Last updated
11/22/2014
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