Healthcare Provider Details

I. General information

NPI: 1255434056
Provider Name (Legal Business Name): HOUSEHOLD CARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 04/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 PARAMOUNT BLVD
AMARILLO TX
79109
US

IV. Provider business mailing address

2801 PARAMOUNT BLVD
AMARILLO TX
79109
US

V. Phone/Fax

Practice location:
  • Phone: 806-359-8512
  • Fax: 806-356-9191
Mailing address:
  • Phone: 806-359-8512
  • Fax: 806-356-9191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number009671
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number009671
License Number StateTX

VIII. Authorized Official

Name: HILLARY R BODROW
Title or Position: ADMINISTRATOR
Credential:
Phone: 806-359-8512