Organization
AMAZING LIVING HCS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRISTAN JOSEPH HOGAN (PROGRAM DIRECTOR)
(903) 917-1115
Entity
Organization
Contact information
Practice address
2206 JAHAN TRL, LONGVIEW, TX 75604-2521
(903) 917-1115
Mailing address
PO BOX 3, HUMBLE, TX 77347-0003
(903) 917-1115
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871879775
—
TX
Enumeration date
09/15/2014
Last updated
09/15/2014
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