MEDICARE: TRANQUILITY HOME MED. EQUIPMENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	5038790001	TX

General Provider Information

NPI Number	:	1326042359
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANQUILITY HOME MED. EQUIPMENT

Provider Business Mailing Address
First Line	:	4231 GATECREST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217
Country	:	US
Telephone Number	:	210-967-0100
Fax Number	:	210-967-0118

Provider Business Practice Location Address
First Line	:	4231 GATECREST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217
Country	:	US
Telephone Number	:	210-967-0100
Fax Number	:	210-967-0118

Authorized Official
Title or Position	:	ADMINISTRATIVE ASSOCIATE
Name	:	MRS. PAULA JEANETTE ALBERTHAL
Credential	:	L.V.N.
Telephone Number	:	210-967-0100

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	08/22/2020

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