1275702276 NPI number — ARIEL AMANA HEALTHCARE INC

Table of content: (NPI 1275702276)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275702276 NPI number — ARIEL AMANA HEALTHCARE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARIEL AMANA HEALTHCARE 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:
AMANA HOME HEALTHCARE
Provider Other Organization Name Type Code:
3
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:
1275702276
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/31/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8330 LYNDON B JOHNSON FWY STE 835C
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75243-1166
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-200-4471
Provider Business Mailing Address Fax Number:
469-200-4472

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8111 LYNDON B JOHNSON FWY STE 1365
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75251-1448
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
469-200-4471
Provider Business Practice Location Address Fax Number:
469-200-4472
Provider Enumeration Date:
02/22/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
OHOME
Authorized Official First Name:
OSASOGIE
Authorized Official Middle Name:
ERHABOR
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
972-832-8987

Provider Taxonomy Codes

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

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

  • Identifier: 747318 . This is a "PTAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 747318 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".