# LIFECARE HOME NURSING, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LifeCare Respiratory and Medical Supply Company
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518972488
- **Authorized official:** MRS. NANCY DIANE WILCOX MHSA, RN, BC, CHCE (CEO)
- **Authorized official phone:** (903) 297-9300

## Contact information

- **Practice address:** 1907 JUDSON RD, LONGVIEW, TX 75605-5607
- **Practice address phone:** (903) 553-1928
- **Practice address fax:** (903) 753-1454
- **Mailing address:** 1907 JUDSON RD, LONGVIEW, TX 75605-5607
- **Mailing address phone:** (903) 553-1928
- **Mailing address fax:** (903) 753-1454

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | 0064112 | TX | Yes |

## Other

- **Enumeration date:** 07/29/2006
- **Last updated:** 08/22/2020