MEDICARE: PRESCRIBED 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	009969	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336130301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRESCRIBED HOME HEALTH, INC.

Provider Business Mailing Address
First Line	:	2429 MARTIN LUTHER KING JR DR
Second Line	:
City	:	ORANGE
State	:	TX
Zip	:	77630-1774
Country	:	US
Telephone Number	:	409-670-0026
Fax Number	:	409-670-0047

Provider Business Practice Location Address
First Line	:	2429 MARTIN LUTHER KING JR DR
Second Line	:
City	:	ORANGE
State	:	TX
Zip	:	77630-1774
Country	:	US
Telephone Number	:	409-670-0026
Fax Number	:	409-670-0047

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	MRS. PAMELA LOUISE WILLEY
Credential	:
Telephone Number	:	409-670-0026

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	01/27/2025

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