Provider Demographics
NPI:1952793382
Name:SAN ANTONIO EXTENDED MEDICAL CARE, INC.
Entity Type:Organization
Organization Name:SAN ANTONIO EXTENDED MEDICAL CARE, INC.
Other - Org Name:MED MART
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-697-9933
Mailing Address - Street 1:21195 IH 10 WEST
Mailing Address - Street 2:SUITE 1101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257
Mailing Address - Country:US
Mailing Address - Phone:210-697-9933
Mailing Address - Fax:210-697-8753
Practice Address - Street 1:11726 IH-35 NORTH
Practice Address - Street 2:SUITE 102A
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78233
Practice Address - Country:US
Practice Address - Phone:800-737-2362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies