MEDICARE: HEFTY HEALTHCARE SERVICES 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1285964106
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEFTY HEALTHCARE SERVICES INC.

Provider Business Mailing Address
First Line	:	9100 SOUTHWEST FWY STE 225
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-1583
Country	:	US
Telephone Number	:	281-815-5192
Fax Number	:	832-834-5148

Provider Business Practice Location Address
First Line	:	9100 SOUTHWEST FWY STE 225
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-1583
Country	:	US
Telephone Number	:	281-815-5192
Fax Number	:	832-834-5148

Authorized Official
Title or Position	:	ADON
Name	:	JOSEPH UCHE NWANKWO SR.
Credential	:	RN
Telephone Number	:	832-892-4405

Provider Enumeration Date	:	12/29/2009
Last Update Date	:	01/04/2016

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