Provider Demographics
NPI:1326368044
Name:INCO GLORY HEALTHCARE INC.
Entity Type:Organization
Organization Name:INCO GLORY HEALTHCARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IBUKUN
Authorized Official - Middle Name:NATHANIEL
Authorized Official - Last Name:UDJE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-918-2557
Mailing Address - Street 1:PO BOX 496043
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75049-6043
Mailing Address - Country:US
Mailing Address - Phone:601-918-2557
Mailing Address - Fax:
Practice Address - Street 1:1014 LOBLOLLY PINE DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-2527
Practice Address - Country:US
Practice Address - Phone:601-918-2557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-04
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251J00000X
TXVLL729347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1326368044OtherNPI