MEDICARE: MED-STAT HOME HEALTHCARE INC.

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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1033416862
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MED-STAT HOME HEALTHCARE INC.

Provider Business Mailing Address
First Line	:	5805 CALLAGHAN RD STE 203
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78228-1127
Country	:	US
Telephone Number	:	210-379-8804
Fax Number	:	210-684-6601

Provider Business Practice Location Address
First Line	:	5805 CALLAGHAN RD STE 203
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78228-1127
Country	:	US
Telephone Number	:	210-379-8804
Fax Number	:	210-684-6601

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MATT SCOTT STRANGE
Credential	:
Telephone Number	:	210-379-8804

Provider Enumeration Date	:	02/14/2011
Last Update Date	:	02/14/2011

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