1235177395 NPI number — HUNTLEIGH HOME MEDICAL, LTD.

Table of content: (NPI 1235177395)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235177395 NPI number — HUNTLEIGH HOME MEDICAL, LTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HUNTLEIGH HOME MEDICAL, LTD.
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:
1235177395
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/25/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5626 RANDOLPH BLVD
Provider Second Line Business Mailing Address:
SUITE 2
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78233-6161
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-225-7400
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5626 RANDOLPH BLVD
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78233-6161
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-225-7400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FLORES
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
DAVID
Authorized Official Title or Position:
V.P. OF THE GENERAL PARTNER
Authorized Official Telephone Number:
210-225-7400

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BP3500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 016863-0001 . This is a "SECURE HORIZONS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 530652 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 015531901 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 016863-0001 . This is a "PACIFCARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1028466 . This is a "UNITED HEALTHCARE/ACM" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 086384702 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 086384701 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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