MEDICARE: PLAZA HOME HEALTH CARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	0040639	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	506940	OTHER	TX	BLUE CROSS NUMBER
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205835238
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLAZA HOME HEALTH CARE INC

Provider Business Mailing Address
First Line	:	315 E CALIFORNIA ST
Second Line	:
City	:	GAINESVILLE
State	:	TX
Zip	:	76240-4005
Country	:	US
Telephone Number	:	940-665-1507
Fax Number	:	940-665-8682

Provider Business Practice Location Address
First Line	:	315 E CALIFORNIA ST
Second Line	:
City	:	GAINESVILLE
State	:	TX
Zip	:	76240-4005
Country	:	US
Telephone Number	:	940-665-1507
Fax Number	:	940-665-8682

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MS. DIANNA HUTCHINSON
Credential	:
Telephone Number	:	940-665-1507

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	03/29/2011

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