WACO BLUEBONNET HOLDINGS INC. NPI 1902968464

NPI Information

NPI: 1902968464
Provider Name: WACO BLUEBONNET HOLDINGS, INC.

Doing Business As: BLUEBONNET HEALTH SERVICES

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

Address:
307 LONDONDERRY
WACO, TX
ZIP 76712
Phone: (254) 751-1790
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WACO BLUEBONNET HOLDINGS, INC. is a hospice care community based in Waco, TX. WACO BLUEBONNET HOLDINGS, INC. NPI is 1902968464. The provider is registered as an organization entity type.
The provider Is Doing Business As Bluebonnet Health Services.

The provider's business location address is:

307 LONDONDERRY
WACO, TX
ZIP 76712-915
Phone: (254) 751-1790
Fax: (254) 751-7295

The provider's authorized official is Brent D Mckenzie .
The authorized official title is Ceo and has the following contact phone number (254) 772-5577.

The CLIA number assigned to this NPI record is 45D1091160 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/14/2006 and was last updated on 8/23/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based		010207	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	671532	MEDICARE OSCAR/CERTIFICATION	TEXAS
2	001014534	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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