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General NPI Number Information
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NPI Number | 1992855266
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Entity Type | Organization
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Legal Business Name | CONCORD HOME CARE INC
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 10/20/2010
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Provider Practice Location Address
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Address Line | 303 W SUNSET RD
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City | SAN ANTONIO
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State | TX
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Zip | 78209-1749
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Country | US
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Telephone | 210-822-9507
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Fax | 210-822-9564
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Provider Business Mailing Address
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Address Line | 303 W SUNSET RD SUITE 200
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City | SAN ANTONIO
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State | TX
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Zip | 78209-1749
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Country | US
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Telephone | 210-731-8996
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Fax | 210-731-8895
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Authorized Official
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Title or Position | CEO
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Name | MS. IFEOMA JACQUELINE OKOLO
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Credential | RN
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Telephone | 210-731-8996
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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 | 005170
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License Number State | TX
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