Provider Demographics
NPI:1891772224
Name:A-MED HEALTH LLC
Entity Type:Organization
Organization Name:A-MED HEALTH LLC
Other - Org Name:CHOICE HEALTH AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF GROWTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:LANIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-363-9932
Mailing Address - Street 1:6760 OLD JACKSONVILLE HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-0566
Mailing Address - Country:US
Mailing Address - Phone:903-363-9932
Mailing Address - Fax:817-326-2436
Practice Address - Street 1:8900 EMMETT F LOWRY EXPY STE 102A
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-9117
Practice Address - Country:US
Practice Address - Phone:409-935-0169
Practice Address - Fax:409-933-1770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6964251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001000625Medicaid
TXHH6816OtherBLUE CROSS BLUE SHIELD
TXHH6816OtherBLUE CROSS BLUE SHIELD