Organization
SAN ANGELO HEALTH CARE, LLC
Active
Other names
Professional Medical
Organization subpart
No
Provider details
NPI number
Authorized official
LYNETTE MCDONALD (GENERAL MANAGER)
(325) 653-1077
Entity
Organization
Contact information
Practice address
737 KNICKERBOCKER RD, SAN ANGELO, TX 76903-8777
(325) 653-1077
(325) 658-7035
Mailing address
PO BOX 422, SAN ANGELO, TX 76902-0422
(325) 653-1077
(325) 658-7035
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142999501, 015547501
—
TX
01
—
503791
BLUE CROSS/BLUE SHIELD
TX
Enumeration date
05/01/2006
Last updated
08/09/2013
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