=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588857031
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KEMDEE HEALTH & DIAGNOSTIC SERVICES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2007
-----------------------------------------------------
Last Update Date | 01/04/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 517 TIMBER WAY DR
-----------------------------------------------------
City | LEWISVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75067-7774
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-293-9191
-----------------------------------------------------
Fax | 972-852-9791
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 517 TIMBER WAY DR
-----------------------------------------------------
City | LEWISVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75067-7774
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-293-9191
-----------------------------------------------------
Fax | 972-852-9791
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/OWNER
-----------------------------------------------------
Name | CATHERINE I ENEH
-----------------------------------------------------
Credential | R.N.
-----------------------------------------------------
Telephone | 972-822-0829
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QS1200X
-----------------------------------------------------
Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------