Provider Demographics
NPI:1225243793
Name:MEDONE HEALTHCARE SERVICES, LTD.
Entity Type:Organization
Organization Name:MEDONE HEALTHCARE SERVICES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:KNOCKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-614-5288
Mailing Address - Street 1:PO BOX 29403
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-0403
Mailing Address - Country:US
Mailing Address - Phone:210-614-5288
Mailing Address - Fax:210-614-5294
Practice Address - Street 1:7940 FLOYD CURL DR
Practice Address - Street 2:SUITE 250
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3905
Practice Address - Country:US
Practice Address - Phone:210-614-5288
Practice Address - Fax:210-614-5294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0070190332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4923760001Medicare ID - Type UnspecifiedMEDICARE ID NUMBER