1144262866 NPI number — SAN MARTIN HOME HEALTH, INC

Table of content: (NPI 1144262866)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144262866 NPI number — SAN MARTIN HOME HEALTH, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAN MARTIN HOME HEALTH, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144262866
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/14/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
700 PAREDES AVE
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
BROWNSVILLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78521-2170
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-544-6385
Provider Business Mailing Address Fax Number:
956-544-6536

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 PAREDES AVE
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
BROWNSVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78521-2170
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-544-6385
Provider Business Practice Location Address Fax Number:
956-544-6536
Provider Enumeration Date:
06/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RENTERIA
Authorized Official First Name:
WENDY
Authorized Official Middle Name:
PATRICIA
Authorized Official Title or Position:
ADMINISTRATOR / CFO
Authorized Official Telephone Number:
956-544-6385

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  004014 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3747P1801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0250466-03 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0250466-01 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000112700 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000653800 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0250466-05 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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