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General NPI Number Information
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NPI Number | 1447391008
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Entity Type | Organization
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Legal Business Name | ST. LUKE HOMECARE
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 5405 HURLEY DR
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City | SAN ANTONIO
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State | TX
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Zip | 78238-2414
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Country | US
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Telephone | 210-680-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 5405 HURLEY DR
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City | SAN ANTONIO
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State | TX
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Zip | 78238-2414
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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 | ADMINISTRATOR
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Name | JEFFREY RICO
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Credential |
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Telephone | 210-680-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WA2000X
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Taxonomy Name | Administrator Registered Nurse
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License Number | 522455
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License Number State | TX
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