Provider Demographics
NPI:1629184767
Name:ADMINISTRATIVE MEDICAL ASSOCIATES INC.
Entity Type:Organization
Organization Name:ADMINISTRATIVE MEDICAL ASSOCIATES INC.
Other - Org Name:AMA HOME CARE, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:A
Authorized Official - Last Name:GURKA
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR,CALM
Authorized Official - Phone:979-830-8383
Mailing Address - Street 1:348 STONE HILL DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BRENHAM
Mailing Address - State:TX
Mailing Address - Zip Code:77833-5641
Mailing Address - Country:US
Mailing Address - Phone:979-830-8383
Mailing Address - Fax:979-830-8188
Practice Address - Street 1:348 STONE HILL DR
Practice Address - Street 2:SUITE 101
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-5641
Practice Address - Country:US
Practice Address - Phone:979-830-8383
Practice Address - Fax:979-830-8188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2012-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX004333251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX025091201Medicaid
TX025091201Medicaid