Healthcare Provider Details

I. General information

NPI: 1821061987
Provider Name (Legal Business Name): HOME CARE OF THE PERMIAN BASIN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 07/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 ANDREWS HWY
MIDLAND TX
79701-5818
US

IV. Provider business mailing address

501 ANDREWS HWY
MIDLAND TX
79701-5818
US

V. Phone/Fax

Practice location:
  • Phone: 432-570-7587
  • Fax: 432-682-9593
Mailing address:
  • Phone: 432-570-7587
  • Fax: 432-682-9593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateTX

VIII. Authorized Official

Name: MRS. GUADALUPE R. HERRERA
Title or Position: ADMINISTRATOR/ DIRECTOR OF NURSING
Credential: RN-BSN
Phone: 432-570-7587