MEDICARE: CALVARY CARE GROUP 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	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1275577561
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALVARY CARE GROUP INC

Provider Business Mailing Address
First Line	:	5750 N SAM HOUSTON PKWY E
Second Line	:	STE 301
City	:	HOUSTON
State	:	TX
Zip	:	77032-4090
Country	:	US
Telephone Number	:	281-227-7700
Fax Number	:	281-227-7771

Provider Business Practice Location Address
First Line	:	5750 N SAM HOUSTON PKWY E
Second Line	:	STE 301
City	:	HOUSTON
State	:	TX
Zip	:	77032-4090
Country	:	US
Telephone Number	:	281-227-7700
Fax Number	:	281-227-7771

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	OLUBUNMI ADENIRAN
Credential	:
Telephone Number	:	281-227-7700

Provider Enumeration Date	:	06/16/2006
Last Update Date	:	11/15/2011

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