MEDICARE: EMPIRICAL CARE GROUP, LLC

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	:	1215374525
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPIRICAL CARE GROUP, LLC

Provider Business Mailing Address
First Line	:	1828 EUCLID AVE
Second Line	:	APT 3
City	:	DALLAS
State	:	TX
Zip	:	75206-7427
Country	:	US
Telephone Number	:	504-228-1691
Fax Number	:

Provider Business Practice Location Address
First Line	:	1828 EUCLID AVE
Second Line	:	APT 3
City	:	DALLAS
State	:	TX
Zip	:	75206-7427
Country	:	US
Telephone Number	:	504-228-1691
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CHARLES BRENT JOHNSON
Credential	:
Telephone Number	:	504-228-1691

Provider Enumeration Date	:	05/28/2013
Last Update Date	:	07/03/2014

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