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General NPI Number Information
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NPI Number | 1184867152
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Entity Type | Organization
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Legal Business Name | RGA HEALTHCARE LLC
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Dates
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Enumeration Date | 04/07/2009
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Last Update Date | 08/31/2015
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Provider Practice Location Address
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Address Line | 2304 MIDWESTERN PKWY STE 206
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City | WICHITA FALLS
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State | TX
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Zip | 76308-2342
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Country | US
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Telephone | 940-687-8850
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Fax | 940-687-8851
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Provider Business Mailing Address
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Address Line | 1411 CHICO HWY P O BOX 667
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City | BRIDGEPORT
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State | TX
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Zip | 76426-2213
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Country | US
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Telephone | 940-627-4574
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Fax | 940-683-2691
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Authorized Official
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Title or Position | OWNER
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Name | MR. RONALD G AMMONS
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Credential |
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Telephone | 940-627-4574
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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 |
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License Number State | TX
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