MEDICARE: CHAMBERS HOME HEALTH AGENCY OF NORTHEAST TEXAS COMPANY

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	679171	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	:	1477556827
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAMBERS HOME HEALTH AGENCY OF NORTHEAST TEXAS COMPANY

Provider Business Mailing Address
First Line	:	201 W 20TH ST STE 102
Second Line	:
City	:	MT PLEASANT
State	:	TX
Zip	:	75455-2325
Country	:	US
Telephone Number	:	903-572-9700
Fax Number	:	903-572-2447

Provider Business Practice Location Address
First Line	:	201 W 20TH ST STE 102
Second Line	:
City	:	MT PLEASANT
State	:	TX
Zip	:	75455-2325
Country	:	US
Telephone Number	:	903-572-9700
Fax Number	:	903-572-2447

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	MELISSA CHAMBERS
Credential	:	R.N.
Telephone Number	:	903-572-9700

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	03/15/2019

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