MEDICARE: HARDEMAN HOME HEALTH CARE, 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	:	1255659041
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARDEMAN HOME HEALTH CARE, LLC

Provider Business Mailing Address
First Line	:	613 9TH ST N
Second Line	:
City	:	TEXAS CITY
State	:	TX
Zip	:	77590-7448
Country	:	US
Telephone Number	:	409-655-5259
Fax Number	:	409-655-5532

Provider Business Practice Location Address
First Line	:	613 9TH ST N
Second Line	:
City	:	TEXAS CITY
State	:	TX
Zip	:	77590-7448
Country	:	US
Telephone Number	:	409-655-5259
Fax Number	:	409-655-5532

Authorized Official
Title or Position	:	ADMINISTRATOR/OWNER
Name	:	DORIS M HARDEMAN
Credential	:
Telephone Number	:	409-655-5259

Provider Enumeration Date	:	05/04/2010
Last Update Date	:	05/04/2010

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