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General NPI Number Information
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NPI Number | 1104987627
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Entity Type | Organization
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Legal Business Name | RURAL HOME HEALTH OF WEST TEXAS, INC.
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 04/01/2008
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Provider Practice Location Address
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Address Line | 204 W 5TH ST SUITE A
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City | CRANE
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State | TX
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Zip | 79731-2510
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Country | US
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Telephone | 432-558-3251
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Fax | 432-558-7243
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Provider Business Mailing Address
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Address Line | PO BOX 935
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City | CRANE
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State | TX
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Zip | 79731-0935
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Country | US
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Telephone | 432-558-3251
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Fax | 432-558-7243
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. BONNIE L BURTON
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Credential | R.N.
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Telephone | 432-558-3251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 002412
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License Number State | TX
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