MEDICARE: SUNSHINE HOMECARE 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

General Provider Information

NPI Number	:	1720815848
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSHINE HOMECARE SERVICES LLC

Provider Business Mailing Address
First Line	:	4441 ARBORWOOD TRL
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76123-2731
Country	:	US
Telephone Number	:	817-797-3073
Fax Number	:

Provider Business Practice Location Address
First Line	:	4441 ARBORWOOD TRL
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76123-2731
Country	:	US
Telephone Number	:	817-797-3073
Fax Number	:

Authorized Official
Title or Position	:	CEO / MANAGER
Name	:	CATHERINE FOMUNYOH
Credential	:
Telephone Number	:	817-797-3073

Provider Enumeration Date	:	09/14/2024
Last Update Date	:	09/14/2024

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