MEDICARE: KHANS FAMILY, 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	:	1184855900
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KHANS FAMILY, INC.

Provider Business Mailing Address
First Line	:	1300 BAXTER ST
Second Line	:	#240
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-3053
Country	:	US
Telephone Number	:	704-333-1415
Fax Number	:	704-333-1105

Provider Business Practice Location Address
First Line	:	1300 BAXTER ST
Second Line	:	#240
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-3053
Country	:	US
Telephone Number	:	704-333-1415
Fax Number	:	704-333-1105

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MOHAMMAD KHAN
Credential	:
Telephone Number	:	704-333-1415

Provider Enumeration Date	:	07/28/2009
Last Update Date	:	07/28/2009

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