MEDICARE: CONCERNED HEARTS PEDIATRICS HOME HEALTH 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		TX

General Provider Information

NPI Number	:	1629447743
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONCERNED HEARTS PEDIATRICS HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	6104 AMICABLE CT
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76016-2001
Country	:	US
Telephone Number	:	817-446-3113
Fax Number	:

Provider Business Practice Location Address
First Line	:	6104 AMICABLE CT
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76016-2001
Country	:	US
Telephone Number	:	817-446-3113
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KATHY SOWARDS
Credential	:	LVN
Telephone Number	:	817-446-3113

Provider Enumeration Date	:	09/18/2015
Last Update Date	:	09/18/2015

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