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General NPI Number Information
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NPI Number | 1174050082
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Entity Type | Organization
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Legal Business Name | AMDAR LLC
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Dates
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Enumeration Date | 05/23/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 511 N HEWITT DR STE 3
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City | HEWITT
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State | TX
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Zip | 76643-3093
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Country | US
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Telephone | 254-666-7300
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Fax | 254-666-7303
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Provider Business Mailing Address
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Address Line | 511 N HEWITT DR STE 3
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City | HEWITT
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State | TX
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Zip | 76643-3093
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Country | US
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Telephone | 254-666-7300
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Fax | 254-666-7303
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BRETT RHODES
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Credential |
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Telephone | 254-666-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 11520
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License Number State | TX
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