Provider Demographics
NPI:1235951260
Name:PANHANDLE HOMECARE, LLC
Entity type:Organization
Organization Name:PANHANDLE HOMECARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MABERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-468-8070
Mailing Address - Street 1:101 W RENNER RD STE 420
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-2022
Mailing Address - Country:US
Mailing Address - Phone:972-468-8070
Mailing Address - Fax:
Practice Address - Street 1:1313 W WILSON ST STE A
Practice Address - Street 2:
Practice Address - City:BORGER
Practice Address - State:TX
Practice Address - Zip Code:79007-4421
Practice Address - Country:US
Practice Address - Phone:737-356-3798
Practice Address - Fax:737-381-3453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-30
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health