MEDICARE: TRISTAN HOME HEALTH CARE, 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1528361276
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRISTAN HOME HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	1024 DONALDSON AVENUE
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78228
Country	:	US
Telephone Number	:	210-270-7899
Fax Number	:	210-270-6988

Provider Business Practice Location Address
First Line	:	1024 DONALDSON AVE
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78228-5101
Country	:	US
Telephone Number	:	210-270-7899
Fax Number	:	210-270-6988

Authorized Official
Title or Position	:	CEO
Name	:	MS. VALERIE MONTES
Credential	:
Telephone Number	:	210-270-7899

Provider Enumeration Date	:	12/17/2010
Last Update Date	:	12/28/2010

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