MEDICARE: MED-CERT PAS SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	3747P1801X	Personal Care Attendant
3	374U00000X	Home Health Aide
4	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1386417392
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MED-CERT PAS SERVICES LLC

Provider Business Mailing Address
First Line	:	1919 S SHILOH RD STE 655
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75042-8234
Country	:	US
Telephone Number	:	972-636-4155
Fax Number	:	972-215-7568

Provider Business Practice Location Address
First Line	:	1919 S SHILOH RD STE 655
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75042-8234
Country	:	US
Telephone Number	:	972-636-4155
Fax Number	:	972-215-7568

Authorized Official
Title or Position	:	OWNER
Name	:	MATHEW JOHN
Credential	:
Telephone Number	:	972-636-4155

Provider Enumeration Date	:	11/01/2023
Last Update Date	:	10/21/2024

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Directions to “MED-CERT PAS SERVICES LLC ” Practice Location

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