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General NPI Number Information
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NPI Number | 1508263005
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Entity Type | Organization
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Legal Business Name | KANGAREW INC
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Dates
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Enumeration Date | 11/26/2014
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Last Update Date | 05/16/2023
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Provider Practice Location Address
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Address Line | 4833 BRYANT IRVIN CT SUITE 100
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City | FORT WORTH
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State | TX
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Zip | 76107-7681
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Country | US
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Telephone | 817-427-3241
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Fax | 817-873-5206
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Provider Business Mailing Address
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Address Line | 509 ELIZABETH CIR
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City | YUTAN
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State | NE
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Zip | 68073-5060
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Country | US
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Telephone | 402-625-2606
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MARTIN B REW
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Credential |
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Telephone | 402-689-4331
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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 |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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