Provider Demographics
NPI:1760863989
Name:ISO HEALTHCARE LLC
Entity Type:Organization
Organization Name:ISO HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:LUM
Authorized Official - Last Name:WANDJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-631-6830
Mailing Address - Street 1:1703 MCGARRY LN
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-7959
Mailing Address - Country:US
Mailing Address - Phone:256-631-6830
Mailing Address - Fax:
Practice Address - Street 1:1703 MCGARRY LN
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-7959
Practice Address - Country:US
Practice Address - Phone:256-631-6830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-12
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health