Provider Demographics
NPI:1871114421
Name:ALAMO HEALTH LLC
Entity type:Organization
Organization Name:ALAMO HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PRAVEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAIDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-215-9072
Mailing Address - Street 1:408 US HIGHWAY 90 W STE B
Mailing Address - Street 2:
Mailing Address - City:CASTROVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78009-4548
Mailing Address - Country:US
Mailing Address - Phone:830-931-2116
Mailing Address - Fax:
Practice Address - Street 1:408 US HIGHWAY 90 W STE B
Practice Address - Street 2:
Practice Address - City:CASTROVILLE
Practice Address - State:TX
Practice Address - Zip Code:78009-4548
Practice Address - Country:US
Practice Address - Phone:830-931-2116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy