MEDICARE: AGLOW HOME HEALTH & HOSPICE CARE

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	251G00000X	Community Based Hospice Care Agency
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1326547928
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGLOW HOME HEALTH & HOSPICE CARE

Provider Business Mailing Address
First Line	:	8016 STONEHILL DR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75025-2564
Country	:	US
Telephone Number	:	602-909-8025
Fax Number	:

Provider Business Practice Location Address
First Line	:	8016 STONEHILL DR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75025-2564
Country	:	US
Telephone Number	:	602-909-8025
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. CHARLES E OKPARA
Credential	:
Telephone Number	:	469-702-1948

Provider Enumeration Date	:	02/08/2018
Last Update Date	:	05/23/2019

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