1740219450 NPI number — SOUTHWEST HOME HEALTH CARE, LP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740219450 NPI number — SOUTHWEST HOME HEALTH CARE, LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTHWEST HOME HEALTH CARE, LP
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:
1740219450
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/22/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
801 W ANN ARBOR TRL
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
PLYMOUTH
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48170-1694
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-414-9990
Provider Business Mailing Address Fax Number:
775-258-1535

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7330 SAN PEDRO AVENUE
Provider Second Line Business Practice Location Address:
SUITE 410
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-979-3800
Provider Business Practice Location Address Fax Number:
210-979-3804
Provider Enumeration Date:
07/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BOWERS
Authorized Official First Name:
RONALD
Authorized Official Middle Name:
LAMON
Authorized Official Title or Position:
PT MPT ADMINISTRATOR
Authorized Official Telephone Number:
210-979-3800

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  009659 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 179063601 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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