Active NPI
Oh Susannah LLC
Doing business as dba PHYSICIAN CHOICE; dba Pink Ribbon Mastectomy Services
- Durable Medical Equipment & Medical Supplies
- San Antonio, TX
National Provider Identifier
1518073048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- OH SUSANNAH LLC
- Doing business as
- dba PHYSICIAN CHOICE; dba Pink Ribbon Mastectomy Services
- Practice address
- 332 W Sunset Rd
Suite 2-B
San Antonio, TX 78209-1767 - Phone
- (210) 829-5440
- Fax
- (210) 828-3698
- NPI assigned
- Aug 21, 2006
- Last updated
- May 29, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Susan L. Moreland
- Title
- Owner
- Phone
- (210) 829-5440
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | TX | Primary |
Addresses
Primary practice location
332 W Sunset Rd
Suite 2-B
San Antonio, TX 78209-1767
Mailing address
101 S Skipper Dr
San Antonio, TX 78216-7446
Phone (210) 829-5440
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1814717-02 | Medicaid | TX | |
| 1814717-01 | Medicaid | TX |
Other names 1
- dba PHYSICIAN CHOICE; dba Pink Ribbon Mastectomy Services
National Provider Directory
National Provider Directory- Tax ID family
- Oh Susannah
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Prosthetic/Orthotic Supplier
- San Antonio, TX
- NPI 1659518074
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1243555200000",
"number": "1518073048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 S SKIPPER DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782167446",
"telephone_number": "210-829-5440",
"fax_number": "210-828-3698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "332 W SUNSET RD",
"address_2": "SUITE 2-B",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782091767",
"telephone_number": "210-829-5440",
"fax_number": "210-828-3698"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OH SUSANNAH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-21",
"last_updated": "2009-05-29",
"status": "A",
"authorized_official_last_name": "MORELAND",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "L.",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "210-829-5440",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "TX",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1814717-02",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1814717-01",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "dba PHYSICIAN CHOICE; dba Pink Ribbon Mastectomy Services",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.