MEDICARE: PALLIATIVE CARE & INPATIENTS HOSPICE CORPORATION

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	0000	TX
2	291U00000X	Clinical Medical Laboratory	0000	TX
3	324500000X	Substance Abuse Rehabilitation Facility
4	385H00000X	Respite Care		TX
5	315D00000X	Inpatient Hospice	0000	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0000	OTHER	TX	INPATIENTS HOSPICE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447501945
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALLIATIVE CARE & INPATIENTS HOSPICE CORPORATION

Provider Business Mailing Address
First Line	:	10333 HARWIN DR
Second Line	:	325
City	:	HOUSTON
State	:	TX
Zip	:	77036-1545
Country	:	US
Telephone Number	:	832-332-7235
Fax Number	:	888-767-6398

Provider Business Practice Location Address
First Line	:	3204 W PARK AVE
Second Line	:
City	:	ORANGE
State	:	TX
Zip	:	77630-2024
Country	:	US
Telephone Number	:	832-332-7235
Fax Number	:	888-767-6398

Authorized Official
Title or Position	:	CEO
Name	:	MR. PRECIOUS DESHIELD JOHNSON
Credential	:
Telephone Number	:	832-332-7235

Provider Enumeration Date	:	09/24/2012
Last Update Date	:	09/24/2012

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Directions to “PALLIATIVE CARE & INPATIENTS HOSPICE CORPORATION ” Practice Location

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