Provider Demographics
NPI:1073594958
Name:L & C NURSING SERVICES, INC.
Entity Type:Organization
Organization Name:L & C NURSING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LOLA
Authorized Official - Middle Name:B
Authorized Official - Last Name:RUNNELS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:936-569-9353
Mailing Address - Street 1:818 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75961-4681
Mailing Address - Country:US
Mailing Address - Phone:936-569-9353
Mailing Address - Fax:936-569-8250
Practice Address - Street 1:818 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-4680
Practice Address - Country:US
Practice Address - Phone:936-569-9353
Practice Address - Fax:936-569-8250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX002142251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXSW20606Medicare ID - Type UnspecifiedSUBMITTER ID
TX677275Medicare ID - Type UnspecifiedPROVIDER NUMBER