MEDICARE: O&R GWITS, 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1942687454
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	O&R GWITS, LLC

Provider Business Mailing Address
First Line	:	4201 PALMER DR
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-3432
Country	:	US
Telephone Number	:	817-225-2618
Fax Number	:

Provider Business Practice Location Address
First Line	:	3901 ARLINGTON HIGHLANDS BLVD
Second Line	:	SUITE 200
City	:	ARLINGTON
State	:	TX
Zip	:	76018-6036
Country	:	US
Telephone Number	:	817-225-2618
Fax Number	:

Authorized Official
Title or Position	:	AGENT, CHIEF FINANCIAL OFFICER
Name	:	OBEY C GWITIRA
Credential	:
Telephone Number	:	817-225-2618

Provider Enumeration Date	:	05/04/2015
Last Update Date	:	05/04/2015

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