Convacare Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

109070 Issued in TX

Legal business name

CONVACARE INC

Practice address

4403 74TH St
Lubbock, TX 79424-2307

Phone

(806) 795-0668

Fax

(806) 795-4250

NPI assigned

May 23, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Richard Ruble

Title

President

Phone

(806) 780-7000

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Lakeridge Rehabliltation and Nursing Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272499200000",
    "number": "1821091968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4403 74TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794242307",
            "telephone_number": "806-795-0668",
            "fax_number": "806-795-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 74TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794242307",
            "telephone_number": "806-795-0668",
            "fax_number": "806-795-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVACARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2010-04-29",
        "status": "A",
        "authorized_official_last_name": "RUBLE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "806-780-7000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "109070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4942",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001001028",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171013901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeridge Rehabliltation and Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Consultants in Infectious Diseases
• Edwin A Contreras, M.D PA.
• Haylee Contreras, PHARM. D.
• Justin Manuel Contreras, PHARMD
• Convacare Inc
• Dawn Conwright, CPNP
• Cook Children'S Physician Network
• Caleb John Cook, M.D.
• Corey Rynn Cook, PHARMD
• Huong Cook

• Skilled Nursing Facility in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.