Provider Demographics
NPI:1518955145
Name:H K A CORPORATION
Entity Type:Organization
Organization Name:H K A CORPORATION
Other - Org Name:AMERICAN HOME HEALTH & HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:IRMA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-445-3330
Mailing Address - Street 1:PO BOX 472
Mailing Address - Street 2:
Mailing Address - City:PECOS
Mailing Address - State:TX
Mailing Address - Zip Code:79772-0472
Mailing Address - Country:US
Mailing Address - Phone:432-445-3330
Mailing Address - Fax:432-445-3331
Practice Address - Street 1:1800 S EDDY ST
Practice Address - Street 2:
Practice Address - City:PECOS
Practice Address - State:TX
Practice Address - Zip Code:79772-6420
Practice Address - Country:US
Practice Address - Phone:432-445-3330
Practice Address - Fax:432-445-3331
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HKA CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-07
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00230251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX094653501Medicaid
TX677210Medicare ID - Type UnspecifiedPROVIDER NUMBER