Provider Demographics
NPI:1073757290
Name:UNLIMITED HOME HEALTH CENTER, INC
Entity Type:Organization
Organization Name:UNLIMITED HOME HEALTH CENTER, INC
Other - Org Name:AMERICAN MEDICAL DIRECT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BROCK
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-832-8300
Mailing Address - Street 1:1862 W BITTERS RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-1809
Mailing Address - Country:US
Mailing Address - Phone:210-832-8300
Mailing Address - Fax:210-520-1440
Practice Address - Street 1:1050 SPIRE DR
Practice Address - Street 2:SUITE F
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-6748
Practice Address - Country:US
Practice Address - Phone:928-443-9690
Practice Address - Fax:928-443-9693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-01
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ4088990002Medicare NSC