Healthcare Provider Details

I. General information

NPI: 1548592371
Provider Name (Legal Business Name): H K A CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2010
Last Update Date: 04/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 EAST BROADWAY
VAN HORN TX
79855
US

IV. Provider business mailing address

PO BOX 472
PECOS TX
79772-0472
US

V. Phone/Fax

Practice location:
  • Phone: 432-283-1238
  • Fax: 432-283-8317
Mailing address:
  • Phone: 432-283-1238
  • Fax: 432-283-8317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: IRMA CASTILLO
Title or Position: CFO
Credential:
Phone: 432-445-3330