Provider Demographics
NPI:1184867152
Name:RGA HEALTHCARE LLC
Entity Type:Organization
Organization Name:RGA HEALTHCARE LLC
Other - Org Name:RGA HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:G
Authorized Official - Last Name:AMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-627-4574
Mailing Address - Street 1:1411 CHICO HWY
Mailing Address - Street 2:P O BOX 667
Mailing Address - City:BRIDGEPORT
Mailing Address - State:TX
Mailing Address - Zip Code:76426-2213
Mailing Address - Country:US
Mailing Address - Phone:940-627-4574
Mailing Address - Fax:940-683-2691
Practice Address - Street 1:2304 MIDWESTERN PKWY
Practice Address - Street 2:STE 206
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-2342
Practice Address - Country:US
Practice Address - Phone:940-687-8850
Practice Address - Fax:940-687-8851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-07
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health