MEDICARE: SHIFTBAY, 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	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1336444504
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHIFTBAY, INC.

Provider Business Mailing Address
First Line	:	2400 AUGUSTA DR STE 329
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-4964
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 AUGUSTA DR STE 329
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-4964
Country	:	US
Telephone Number	:	713-429-4738
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOSHUA BERRY
Credential	:
Telephone Number	:	713-429-4738

Provider Enumeration Date	:	01/20/2011
Last Update Date	:	01/20/2011

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Directions to “SHIFTBAY, INC. ” Practice Location

Language	Start Address	Practice Location

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