Provider Demographics
NPI:1427012954
Name:LANDMARK HEALTHCARE INC
Entity Type:Organization
Organization Name:LANDMARK HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MAJERUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-529-2121
Mailing Address - Street 1:3515 NW JIM WRIGHT FWY
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76106-3200
Mailing Address - Country:US
Mailing Address - Phone:817-338-0007
Mailing Address - Fax:817-338-0816
Practice Address - Street 1:8200 TRISTAR DR STE 120
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-2863
Practice Address - Country:US
Practice Address - Phone:866-388-3883
Practice Address - Fax:888-249-3132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-13
Last Update Date:2022-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27725251F00000X, 332BP3500X, 333600000X, 3336C0003X, 3336C0004X, 3336H0001X, 3336S0011X
TX0080100332B00000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX194883801Medicaid