MEDICARE: FAIRFIELD HOSPICE AND 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	3140N1450X	Pediatric Skilled Nursing Facility

General Provider Information

NPI Number	:	1376933325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAIRFIELD HOSPICE AND HOME HEALTH, INC

Provider Business Mailing Address
First Line	:	5610 AVIS HILL COURT
Second Line	:
City	:	FULSHEAR
State	:	TX
Zip	:	77441
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2918 N RICHMOND RD
Second Line	:
City	:	WHARTON
State	:	TX
Zip	:	77488-2006
Country	:	US
Telephone Number	:	713-774-1128
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. OLOTIN A ALATAN
Credential	:
Telephone Number	:	713-774-1128

Provider Enumeration Date	:	01/29/2015
Last Update Date	:	01/29/2015

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