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General NPI Number Information
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NPI Number | 1245787878
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Entity Type | Organization
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Legal Business Name | NEWLEAF HEALTH, LLC
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 1313 GRANGER DRIVE
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City | ALLEN
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State | TX
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Zip | 75013-1123
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Country | US
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Telephone | 214-396-5009
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 46
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City | ALLEN
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State | TX
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Zip | 75013-0002
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | CHARLES ZANE LEWIS
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Credential |
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Telephone | 214-396-5009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1001420
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License Number State | TX
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