MEDICARE: WINGS HOSPICE CARE 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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1740737733
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINGS HOSPICE CARE LLC

Provider Business Mailing Address
First Line	:	4313 N 10TH ST STE G1
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-3066
Country	:	US
Telephone Number	:	956-992-0895
Fax Number	:	956-992-8910

Provider Business Practice Location Address
First Line	:	4313 N 10TH ST STE G1
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-3066
Country	:	US
Telephone Number	:	956-992-0895
Fax Number	:	956-992-8910

Authorized Official
Title or Position	:	OWNER / ADMINISTRATOR
Name	:	GLORIA VELA
Credential	:
Telephone Number	:	956-992-0895

Provider Enumeration Date	:	09/07/2016
Last Update Date	:	09/07/2016

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