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General NPI Number Information
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NPI Number | 1598537714
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Entity Type | Organization
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Legal Business Name | TOTALCARE COMPREHENSIVE HOME HEALTH SUPPLY, LTD.
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Dates
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Enumeration Date | 10/23/2023
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Last Update Date | 11/22/2023
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Provider Practice Location Address
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Address Line | 2526 MANANA DR STE 205
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City | DALLAS
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State | TX
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Zip | 75220-1230
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Country | US
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Telephone | 903-592-3300
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Fax | 888-633-7575
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Provider Business Mailing Address
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Address Line | 4413 TYLER PARK DR STE A
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City | TYLER
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State | TX
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Zip | 75703-3123
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Country | US
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Telephone | 903-592-3300
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Fax | 888-633-7575
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Authorized Official
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Title or Position | CEO
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Name | JONATHAN MARCUS LEICHLITER
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Credential |
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Telephone | 903-592-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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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 | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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