Provider Demographics
NPI:1023062148
Name:MIDLAND CARESERVICES LLC
Entity type:Organization
Organization Name:MIDLAND CARESERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:W
Authorized Official - Last Name:EDDINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-469-6739
Mailing Address - Street 1:2301 HIGHWAY 1187
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-6124
Mailing Address - Country:US
Mailing Address - Phone:817-469-6739
Mailing Address - Fax:817-801-3486
Practice Address - Street 1:1030 ANDREWS HWY STE 109
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-3807
Practice Address - Country:US
Practice Address - Phone:432-687-3327
Practice Address - Fax:432-687-3861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9918251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX677864Medicare Oscar/Certification