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General NPI Number Information
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NPI Number | 1710910419
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Entity Type | Organization
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Legal Business Name | FOUR STAR HOME HEALTH CARE, INC.
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 11/14/2007
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Provider Practice Location Address
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Address Line | 1915 S AUSTIN AVE SUITE 108
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City | GEORGETOWN
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State | TX
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Zip | 78626-7843
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Country | US
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Telephone | 512-864-9994
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Fax | 512-864-9954
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Provider Business Mailing Address
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Address Line | 1915 S AUSTIN AVE SUITE 108
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City | GEORGETOWN
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State | TX
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Zip | 78626-7843
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Country | US
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Telephone | 512-864-9994
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Fax | 512-864-9954
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Authorized Official
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Title or Position | CFO
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Name | MRS. ROSEMARY C NWANKPA
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Credential | ACCOUNTANT
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Telephone | 512-446-5335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 009344
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License Number State | TX
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