MEDICARE: CHARTWELL MEDICAL SOLUTIONS, 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	171W00000X	Contractor

General Provider Information

NPI Number	:	1720325368
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHARTWELL MEDICAL SOLUTIONS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 121390
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-1390
Country	:	US
Telephone Number	:	817-583-8201
Fax Number	:

Provider Business Practice Location Address
First Line	:	2225 E RANDOL MILL RD
Second Line	:	SUITE 101
City	:	ARLINGTON
State	:	TX
Zip	:	76011-6315
Country	:	US
Telephone Number	:	817-583-8201
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CONSTANCE A CRUTCHFIELD
Credential	:
Telephone Number	:	817-583-8201

Provider Enumeration Date	:	01/15/2013
Last Update Date	:	01/15/2013

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