Healthcare Provider Details

I. General information

NPI: 1740602648
Provider Name (Legal Business Name): ZOOM HOME HEALTHCARE INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2014
Last Update Date: 01/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12959 JUPITER RD STE 254
DALLAS TX
75238-5250
US

IV. Provider business mailing address

12959 JUPITER RD STE 254
DALLAS TX
75238-5250
US

V. Phone/Fax

Practice location:
  • Phone: 682-553-7706
  • Fax:
Mailing address:
  • Phone: 682-553-7706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: GEORGE OKWUCHUKWU NEBE
Title or Position: ADMINISTRATOR
Credential:
Phone: 682-553-7706