Provider Demographics
NPI:1962670356
Name:RECOVERY HOME HEALTHCARE SYSTEMS
Entity Type:Organization
Organization Name:RECOVERY HOME HEALTHCARE SYSTEMS
Other - Org Name:ADVANCED MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-303-2277
Mailing Address - Street 1:2620 W PIONEER PKWY
Mailing Address - Street 2:STE: 101
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-5904
Mailing Address - Country:US
Mailing Address - Phone:817-303-2277
Mailing Address - Fax:
Practice Address - Street 1:2620 W PIONEER PKWY
Practice Address - Street 2:STE: 101
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-5904
Practice Address - Country:US
Practice Address - Phone:817-303-2277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RECOVERY HOME HEALTH CARE SYSTEMS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-19
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1094290003Medicare NSC