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General NPI Number Information
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NPI Number | 1821124769
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Entity Type | Organization
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Legal Business Name | AMIGO HEALTHCARE, INC.
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1812 COMMERCE DR SUITE 3B
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City | LAREDO
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State | TX
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Zip | 78041-2843
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Country | US
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Telephone | 956-795-8705
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Fax | 956-791-2554
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Provider Business Mailing Address
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Address Line | PO BOX 1908
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City | LAREDO
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State | TX
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Zip | 78044-1908
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Country | US
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Telephone | 956-795-8705
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Fax | 956-791-2554
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. CARLOS GARZA
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Credential |
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Telephone | 956-795-8705
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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 | 011000
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License Number State | TX
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