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General NPI Number Information
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NPI Number | 1962433490
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Entity Type | Organization
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Legal Business Name | AMIGO HOME HEALTH AGENCY, INC
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 12/27/2011
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Provider Practice Location Address
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Address Line | 316 N TEXAS BLVD
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City | WESLACO
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State | TX
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Zip | 78596-5306
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Country | US
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Telephone | 956-968-8530
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Fax | 956-969-9502
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Provider Business Mailing Address
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Address Line | PO BOX 175
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City | WESLACO
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State | TX
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Zip | 78599-0175
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Country | US
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Telephone | 956-968-8530
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Fax | 956-969-9502
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Authorized Official
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Title or Position | CEO / PRESIDENT/ADMINISTRATOR
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Name | EDELMIRO VARELA JR.
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Credential | R.N.
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Telephone | 956-968-8530
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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 | 007809
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License Number State | TX
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