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General NPI Number Information
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NPI Number | 1912130931
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Entity Type | Organization
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Legal Business Name | SAN ANTONIO MEDICAL SUPPLIES
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Dates
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Enumeration Date | 08/25/2009
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Last Update Date | 08/25/2009
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Provider Practice Location Address
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Address Line | 1500 FREDERICKSBURG RD SUITE B
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City | SAN ANTONIO
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State | TX
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Zip | 78201-5029
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Country | US
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Telephone | 210-737-7267
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Fax | 210-737-7262
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Provider Business Mailing Address
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Address Line | 1500 FREDERICKSBURG RD SUITE B
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City | SAN ANTONIO
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State | TX
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Zip | 78201-5029
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Country | US
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Telephone | 210-737-7267
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Fax | 210-737-7262
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Authorized Official
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Title or Position | OWNER/PARTNER
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Name | MS. DONNA REYNA
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Credential | OTHER
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Telephone | 210-737-7268
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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 | 0108615
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License Number State | TX
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