MEDICARE: CHARLES EDWARD MCGRIFF

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	010896	TX

General Provider Information

NPI Number	:	1346365640
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHARLES EDWARD MCGRIFF

Provider Business Mailing Address
First Line	:	2915 S LANCASTER RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75216-4418
Country	:	US
Telephone Number	:	214-371-8888
Fax Number	:

Provider Business Practice Location Address
First Line	:	2915 S LANCASTER RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75216-4418
Country	:	US
Telephone Number	:	214-371-8888
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. CHARLES EDWARD MCGRIFF
Credential	:
Telephone Number	:	214-729-0874

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	11/08/2007

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