MEDICARE: NORTH STAR HOME HEALTHCARE SERVICES, 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	:	1235912353
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH STAR HOME HEALTHCARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	15508 TAYLORCREST DR RM A
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77306-2240
Country	:	US
Telephone Number	:	714-829-8903
Fax Number	:

Provider Business Practice Location Address
First Line	:	15508 TAYLORCREST DR RM A
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77306-2240
Country	:	US
Telephone Number	:	714-829-8903
Fax Number	:

Authorized Official
Title or Position	:	COMPLIANCE OFFICER
Name	:	MARCK ANTON TAMAYO
Credential	:
Telephone Number	:	714-829-8903

Provider Enumeration Date	:	08/14/2023
Last Update Date	:	08/14/2023

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