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General NPI Number Information
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NPI Number | 1710219720
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Entity Type | Organization
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Legal Business Name | TOTALCARE COMPREHENSIVE HOME HEALTH SUPPLY
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Dates
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Enumeration Date | 02/02/2010
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Last Update Date | 02/02/2010
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Provider Practice Location Address
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Address Line | 1100 STONE RD SUITE 105
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City | KILGORE
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State | TX
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Zip | 75662-5482
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Country | US
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Telephone | 903-986-3792
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Fax | 903-986-3793
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Provider Business Mailing Address
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Address Line | 401 E FRONT ST SUITE 224
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City | TYLER
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State | TX
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Zip | 75702-8213
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Country | US
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Telephone | 903-592-3300
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Fax | 903-592-3301
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Authorized Official
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Title or Position | OWNER
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Name | GREG ORTIZ
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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 | 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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