Provider Demographics
NPI:1255325338
Name:TURTLE HEALTHCARE GROUP LLC
Entity type:Organization
Organization Name:TURTLE HEALTHCARE GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MANCINAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-867-6344
Mailing Address - Street 1:720 E DOVE AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-0463
Mailing Address - Country:US
Mailing Address - Phone:956-787-5259
Mailing Address - Fax:956-787-5488
Practice Address - Street 1:720 E DOVE AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-0463
Practice Address - Country:US
Practice Address - Phone:956-787-5259
Practice Address - Fax:956-787-5488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-06
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 332BP3500X, 333600000X, 3336C0004X, 3336H0001X
TX202203336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2099667OtherPK
TX172828901Medicaid
TX172828901Medicaid
TX5350550001Medicare ID - Type UnspecifiedMEDICARE
TX172828902Medicaid