Organization
OH SUSANNAH LLC
Active
Other names
dba PHYSICIAN CHOICE; dba Pink Ribbon Mastectomy Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN L. MORELAND (OWNER)
(210) 829-5440
Entity
Organization
Contact information
Practice address
332 W SUNSET RD, SUITE 2-B, SAN ANTONIO, TX 78209-1767
(210) 829-5440
(210) 828-3698
Mailing address
101 S SKIPPER DR, SAN ANTONIO, TX 78216-7446
(210) 829-5440
(210) 828-3698
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1814717-01
—
TX
05
—
1814717-02
—
TX
Enumeration date
08/21/2006
Last updated
05/29/2009
Update your record
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