MEDICARE: EDNA M. LEWIN

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

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316999063
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDNA M. LEWIN

Provider Business Mailing Address
First Line	:	7215 LA GRANADA DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-4136
Country	:	US
Telephone Number	:	281-575-0526
Fax Number	:	281-575-0057

Provider Business Practice Location Address
First Line	:	7215 LA GRANADA DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-4136
Country	:	US
Telephone Number	:	281-575-0526
Fax Number	:	281-575-0057

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. EDNA MAE LEWIN
Credential	:	RN, MSN
Telephone Number	:	281-575-0526

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	11/23/2009

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