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General NPI Number Information
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NPI Number | 1669485561
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Entity Type | Organization
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Legal Business Name | BELLCOA HOME HEALTH SERVICE, INC
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 04/11/2017
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Provider Practice Location Address
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Address Line | 7801 N. LAMAR BLVD SUITE D-79
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City | AUSTIN
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State | TX
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Zip | 78752-1039
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Country | US
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Telephone | 512-533-9990
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Fax | 512-533-9992
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Provider Business Mailing Address
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Address Line | 7801 N. LAMAR BLVD SUITE D-79
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City | AUSTIN
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State | TX
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Zip | 78752-1039
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Country | US
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Telephone | 512-533-9990
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Fax | 512-533-9992
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Authorized Official
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Title or Position | CFO
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Name | MR. KOLAWOLE R OLASUPO
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Credential |
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Telephone | 512-608-8292
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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 | 17027
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License Number State | TX
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