MEDICARE: MEDEX HEALTHCARE 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	:	1427312735
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDEX HEALTHCARE SERVICES LLC

Provider Business Mailing Address
First Line	:	7007 BALLINGER RIDGE LN
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-4058
Country	:	US
Telephone Number	:	832-275-2814
Fax Number	:

Provider Business Practice Location Address
First Line	:	7007 BALLINGER RIDGE LN
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-4058
Country	:	US
Telephone Number	:	832-275-2814
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOSEPH UKONU
Credential	:
Telephone Number	:	832-595-8171

Provider Enumeration Date	:	07/02/2012
Last Update Date	:	07/02/2012

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