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NPI Code Detail

MEDICARE: BETHESDA, INCORPORATED

MEDICARE: BETHESDA, INCORPORATED
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
1251E00000XHome Health Agency009725TX

General Provider Information

NPI Number : 1003862947
Entity Type Code : Organization
Provider Name (Legal Business Name) : BETHESDA, INCORPORATED
Provider Business Mailing Address
First Line : 873 S STEMMONS FWY STE 100
Second Line :
City : LEWISVILLE
State : TX
Zip : 75067-5351
Country : US
Telephone Number : 972-459-9999
Fax Number : 972-315-2065
Provider Business Practice Location Address
First Line : 873 S STEMMONS FWY STE 100
Second Line :
City : LEWISVILLE
State : TX
Zip : 75067-5351
Country : US
Telephone Number : 972-459-9999
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR/DON
Name : KEHINDE ROMOKE AMOSUN
Credential : RN
Telephone Number : 972-420-0741
Provider Enumeration Date : 05/25/2006
Last Update Date : 04/05/2019

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Directions to “BETHESDA, INCORPORATED ” Practice Location

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