Provider Demographics
NPI:1881609758
Name:RITA A JEANE
Entity type:Organization
Organization Name:RITA A JEANE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:JEANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-978-2181
Mailing Address - Street 1:8030 HIGHWAY 6
Mailing Address - Street 2:
Mailing Address - City:HITCHCOCK
Mailing Address - State:TX
Mailing Address - Zip Code:77563-1741
Mailing Address - Country:US
Mailing Address - Phone:409-978-2181
Mailing Address - Fax:409-978-2275
Practice Address - Street 1:8030 HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:HITCHCOCK
Practice Address - State:TX
Practice Address - Zip Code:77563-1741
Practice Address - Country:US
Practice Address - Phone:409-978-2181
Practice Address - Fax:409-978-2275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0041655332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1281200001Medicare NSC