Healthcare Provider Details
I. General information
NPI: 1790879542
Provider Name (Legal Business Name): ESHNA, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/03/2006
Last Update Date: 04/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
115 W. WASHINGTON AVE.
WHITNEY TX
76692-2120
US
IV. Provider business mailing address
PO BOX 458
WHITNEY TX
76692-0458
US
V. Phone/Fax
- Phone: 254-694-6626
- Fax: 254-694-6391
- Phone: 254-694-6626
- Fax: 254-694-6391
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | 009332 |
| License Number State | TX |
VIII. Authorized Official
Name: MR.
JOE
D
WHITE
Title or Position: BUSINESS MANAGER
Credential:
Phone: 254-697-6591