MEDICARE: 7 SISTERS CARE HEALTH BOUTIQUE,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	335E00000X	Prosthetic/Orthotic Supplier	32039073146	TX

General Provider Information

NPI Number	:	1558502005
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	7 SISTERS CARE HEALTH BOUTIQUE,INC.

Provider Business Mailing Address
First Line	:	2015 MULBERRY AVE
Second Line	:	STE 320
City	:	MOUNT PLEASANT
State	:	TX
Zip	:	75455-2362
Country	:	US
Telephone Number	:	903-572-0058
Fax Number	:	903-577-9665

Provider Business Practice Location Address
First Line	:	2015 MULBERRY AVE
Second Line	:	STE. 320
City	:	MOUNT PLEASANT
State	:	TX
Zip	:	75455-2362
Country	:	US
Telephone Number	:	903-572-0058
Fax Number	:	903-577-9665

Authorized Official
Title or Position	:	VP/MGR
Name	:	ELIZABETH T HESS
Credential	:
Telephone Number	:	903-572-0058

Provider Enumeration Date	:	03/13/2009
Last Update Date	:	04/26/2011

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