Provider Demographics
NPI:1114206588
Name:I.V. CARE OF S.A, INC.
Entity Type:Organization
Organization Name:I.V. CARE OF S.A, INC.
Other - Org Name:NETCARE DME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:BUCHMEIER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:210-490-4320
Mailing Address - Street 1:6428 BANDERA RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-1511
Mailing Address - Country:US
Mailing Address - Phone:210-256-8629
Mailing Address - Fax:210-256-8199
Practice Address - Street 1:810 SE MILITARY DR
Practice Address - Street 2:SUITE A
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78214-2823
Practice Address - Country:US
Practice Address - Phone:210-923-4493
Practice Address - Fax:210-923-4166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18620251E00000X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167964901OtherTPI#
TX144664Medicaid
TX167964902OtherTPI#
TX167964901OtherTPI#