# WEST SIDE PRIMARY HOME CARE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609165935
- **Authorized official:** MRS. EDNA VERNETTE CARRANZA MSN, RN (ADMINISTRATOR/OWNER)
- **Authorized official phone:** (956) 723-1856

## Contact information

- **Practice address:** 539 N GENERAL MCMULLEN DR, SUITE 106, SAN ANTONIO, TX 78228-6262
- **Practice address phone:** (210) 433-3133
- **Practice address fax:** (210) 433-3177
- **Mailing address:** 539 N GENERAL MCMULLEN DR, SUITE 106, SAN ANTONIO, TX 78228-6262
- **Mailing address phone:** (210) 433-3133
- **Mailing address fax:** (210) 433-3177

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 04/07/2011
- **Last updated:** 04/07/2011