Organization
BOLTON HEALTHCARE, L.L.C.
Active
Other names
Guardian Angel Durable Medical Equipment
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KAREN MARIE ALLEN (DME ASSITANT ADMINISTRATOR)
(409) 925-7303
Entity
Organization
Contact information
Practice address
12627 HIGHWAY 6, SANTA FE, TX 77510-7613
(409) 925-7303
Mailing address
12627 HIGHWAY 6, SANTA FE, TX 77510-7613
(409) 925-7303
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0085042
TX
332BC3200X
Customized Equipment (DME)
0085042
TX
332BD1200X
Dialysis Equipment & Supplies (DME)
0085042
TX
332BN1400X
Nursing Facility Supplies (DME)
0085042
TX
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
0085042
TX
332BX2000X
Oxygen Equipment & Supplies (DME)
0085042
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194755991
OLD NPI
TX
Enumeration date
08/04/2008
Last updated
12/09/2008
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