MEDICARE: A&T MULTI-HEALTHCARE SERVICES 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
1	251E00000X	Home Health Agency	010423	TX

General Provider Information

NPI Number	:	1417071200
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A&T MULTI-HEALTHCARE SERVICES LLC

Provider Business Mailing Address
First Line	:	7100 REGENCY SQUARE BLVD
Second Line	:	SUITE 180
City	:	HOUSTON
State	:	TX
Zip	:	77036-3202
Country	:	US
Telephone Number	:	713-723-0425
Fax Number	:	713-728-9224

Provider Business Practice Location Address
First Line	:	7100 REGENCY SQUARE BLVD
Second Line	:	SUITE 180
City	:	HOUSTON
State	:	TX
Zip	:	77036-3187
Country	:	US
Telephone Number	:	713-723-0425
Fax Number	:	713-728-9224

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. TIMAH MOSES FOMUNYOH
Credential	:	MBA
Telephone Number	:	713-723-0425

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	03/31/2017

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