Provider Demographics
NPI:1922102599
Name:LAREDO TEXAS HOME CARE SERVICES COMPANY, LP
Entity Type:Organization
Organization Name:LAREDO TEXAS HOME CARE SERVICES COMPANY, LP
Other - Org Name:DBA LAREDO HOME MEDICAL EQUIPMENT
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MIKEAL
Authorized Official - Last Name:GREENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-794-8220
Mailing Address - Street 1:1610 E BUSTAMANTE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-5455
Mailing Address - Country:US
Mailing Address - Phone:956-794-8220
Mailing Address - Fax:956-794-8224
Practice Address - Street 1:1610 E BUSTAMANTE ST
Practice Address - Street 2:SUITE A
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-5455
Practice Address - Country:US
Practice Address - Phone:956-794-8220
Practice Address - Fax:956-794-8224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0086843332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1795692-02Medicaid
TX1795692-01Medicaid
TX5570230001Medicare NSC