MEDICARE: PHYSICIANS HOME CARE SERVICES, LLC

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	:	1366767386
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIANS HOME CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	6659 SULLIVAN RD
Second Line	:
City	:	GREENWELL SPRINGS
State	:	LA
Zip	:	70739-3112
Country	:	US
Telephone Number	:	225-261-0160
Fax Number	:	225-775-9800

Provider Business Practice Location Address
First Line	:	6659 SULLIVAN RD
Second Line	:
City	:	GREENWELL SPRINGS
State	:	LA
Zip	:	70739-3112
Country	:	US
Telephone Number	:	225-261-0160
Fax Number	:	225-775-9800

Authorized Official
Title or Position	:	CEO
Name	:	MRS. ANNETTE AUSTIN
Credential	:
Telephone Number	:	225-261-0160

Provider Enumeration Date	:	04/01/2010
Last Update Date	:	04/01/2010

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