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General NPI Number Information
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NPI Number | 1376659557
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Entity Type | Organization
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Legal Business Name | LIFECARE REUSS PHARMACY LLC
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 11/02/2020
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Provider Practice Location Address
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Address Line | 515 N ESPLANADE ST
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City | CUERO
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State | TX
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Zip | 77954-3603
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Country | US
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Telephone | 361-275-3412
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Fax | 361-275-6399
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Provider Business Mailing Address
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Address Line | PO BOX 270
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City | CUERO
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State | TX
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Zip | 77954-0270
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Country | US
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Telephone | 361-275-3412
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Fax | 361-275-6399
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Authorized Official
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Title or Position | DME COORDINATOR
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Name | LINDA J ZENGERLE
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Credential |
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Telephone | 361-275-3412
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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 | 30017
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 30017
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 335G00000X
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Taxonomy Name | Medical Foods Supplier
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License Number | 30017
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License Number State | TX
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