Providence Health Services of Waco
NPI #1184158362 in Lacy Lakeview, Texas
Provider Information
- NPI Number
- 1184158362
- Entity Type
- Organization
- Organization Name
- Providence Health Services of Waco
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- Apr 14, 2017
- Last Updated
- Nov 20, 2017
Practice Location
- Address
- 1130 N LOOP 340
- City
- Lacy Lakeview
- State
- Texas
- ZIP Code
- 76705
- Phone
- (254) 870-6480
Authorized Official
- Name
- CRAIG CORDOLA
- Title
- CEO
- Phone
- (512) 324-1000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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