MEDICARE: SHEPHARD HOME HEALTH 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	:	1306897590
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHEPHARD HOME HEALTH INC.

Provider Business Mailing Address
First Line	:	655 W ILLINOIS AVE
Second Line	:	SUITE 911
City	:	DALLAS
State	:	TX
Zip	:	75224-1817
Country	:	US
Telephone Number	:	972-904-4292
Fax Number	:

Provider Business Practice Location Address
First Line	:	655 W ILLINOIS AVE
Second Line	:	SUITE 911
City	:	DALLAS
State	:	TX
Zip	:	75224-1817
Country	:	US
Telephone Number	:	972-904-4292
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MR. FRANCIS OSAGIE
Credential	:
Telephone Number	:	972-904-4292

Provider Enumeration Date	:	05/13/2006
Last Update Date	:	08/22/2020

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