Provider Demographics
NPI:1477234839
Name:DREX HOME CARE LLC
Entity type:Organization
Organization Name:DREX HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:NEUBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-230-8917
Mailing Address - Street 1:930 WEBSTER AVE
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76706-1544
Mailing Address - Country:US
Mailing Address - Phone:254-522-7326
Mailing Address - Fax:
Practice Address - Street 1:719 W FRONT ST STE 276
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-7977
Practice Address - Country:US
Practice Address - Phone:254-522-7326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-28
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care