MEDICARE: KEMG HOME HEALTH CARE 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	011359	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	:	1376631952
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEMG HOME HEALTH CARE INC

Provider Business Mailing Address
First Line	:	810 DALWORTH ST STE A
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75050-5545
Country	:	US
Telephone Number	:	972-262-4300
Fax Number	:	972-262-4302

Provider Business Practice Location Address
First Line	:	810A DALWORTH ST STE A
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75050-5545
Country	:	US
Telephone Number	:	972-262-4300
Fax Number	:	972-262-4302

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. MIGUEL VILLANUEVA
Credential	:
Telephone Number	:	972-262-4300

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	07/05/2019

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Directions to “KEMG HOME HEALTH CARE INC ” Practice Location

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