=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598040396
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NAM HOME HEALTH CARE SERVICES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/13/2011
-----------------------------------------------------
Last Update Date | 12/26/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 960 TERRACOTTA DR
-----------------------------------------------------
City | ALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75013-4871
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-835-6114
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 960 TERRACOTTA DR
-----------------------------------------------------
City | ALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75013-4871
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-835-6714
-----------------------------------------------------
Fax | 214-383-5156
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | RN
-----------------------------------------------------
Name | MISS OSAYUWAMEN JOYCE EHIOGHAE
-----------------------------------------------------
Credential | NURSE
-----------------------------------------------------
Telephone | 469-835-6714
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 18667818833
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------