Provider Demographics
NPI:1083626295
Name:TOTALCARE COMPREHENSIVE HOME HEALTH SUPPLY, LTD.
Entity Type:Organization
Organization Name:TOTALCARE COMPREHENSIVE HOME HEALTH SUPPLY, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JETRE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-592-3300
Mailing Address - Street 1:4413 TYLER PARK DR STE A
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-3123
Mailing Address - Country:US
Mailing Address - Phone:903-592-3300
Mailing Address - Fax:903-592-3301
Practice Address - Street 1:4413 TYLER PARK DR STE A
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-3123
Practice Address - Country:US
Practice Address - Phone:903-592-3300
Practice Address - Fax:903-592-3301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165742102Medicaid
TX165742101Medicaid
TX165742102Medicaid