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NPI Code Detail

MEDICARE: WINIFRED I EDOSAH LLC

MEDICARE: WINIFRED I EDOSAH LLC
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
1251J00000XNursing Care Agency
2251E00000XHome Health Agency

General Provider Information

NPI Number : 1255196960
Entity Type Code : Organization
Provider Name (Legal Business Name) : WINIFRED I EDOSAH LLC
Provider Business Mailing Address
First Line : 4534 WYATT ROLAND WAY
Second Line :
City : RICHMOND
State : TX
Zip : 77406-2657
Country : US
Telephone Number : 832-335-5514
Fax Number :
Provider Business Practice Location Address
First Line : 4534 WYATT ROLAND WAY
Second Line :
City : RICHMOND
State : TX
Zip : 77406-2657
Country : US
Telephone Number : 832-335-5514
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : WINIFRED EDOSAH
Credential : REGISTERED NURSE
Telephone Number : 832-335-5514
Provider Enumeration Date : 02/21/2024
Last Update Date : 07/11/2024

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Directions to “WINIFRED I EDOSAH LLC ” Practice Location

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