Provider Demographics
NPI:1790783819
Name:NEWCHANNEL INCORPORATED
Entity Type:Organization
Organization Name:NEWCHANNEL INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:OKECHUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:OGBUJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-242-7007
Mailing Address - Street 1:PO BOX 36932
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77236-6932
Mailing Address - Country:US
Mailing Address - Phone:713-668-4141
Mailing Address - Fax:713-668-4142
Practice Address - Street 1:2646 S LOOP W
Practice Address - Street 2:SUITE 270 & 270A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2665
Practice Address - Country:US
Practice Address - Phone:713-668-4141
Practice Address - Fax:713-668-4142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009419251E00000X
TX0065451332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170673102Medicaid
TX170673101Medicaid
TX170673102Medicaid
TX4724360001Medicare NSC