1801889134 NPI number — LOBO HOME HEALTH INC.

Table of content: (NPI 1801889134)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801889134 NPI number — LOBO HOME HEALTH INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOBO 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:
PORCH HOME MEDICAL
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:
1801889134
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
133 WOODS COVE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCOTTSBORO
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35768-2460
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
256-259-3123
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
133 WOODS COVE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCOTTSBORO
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35768-2460
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-259-3123
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
PORCH
Authorized Official First Name:
LON
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
256-259-3123

Provider Taxonomy Codes

  • Taxonomy code: 332BP3500X , with the licence number:  332BX2000X , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 332BX2000X , with the licence number: 332B00000X , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 119 . This is a "AL BOARD OF HOME MEDICAL" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 3100330 . This is a "BS/BC TN PROVIDER NUM" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 51054007 . This is a "BS/BC AL PROVIDER NUM" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 900044 . This is a "AL STATE BD OF PHARMACY" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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