MEDICARE: MARYANN OBI

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	009593	TX

General Provider Information

NPI Number	:	1578510368
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARYANN OBI

Provider Business Mailing Address
First Line	:	1065 DONIPHAN PARK CIRCLE
Second Line	:	SUIT B
City	:	EL PASO
State	:	TX
Zip	:	79922-2215
Country	:	US
Telephone Number	:	915-581-6313
Fax Number	:	915-842-0533

Provider Business Practice Location Address
First Line	:	1065 DONIPHAN PARK CIRCLE
Second Line	:	SUIT B
City	:	EL PASO
State	:	TX
Zip	:	79922-2215
Country	:	US
Telephone Number	:	915-581-6313
Fax Number	:	915-842-0533

Authorized Official
Title or Position	:	ASST ADMINISTRATOR/CFO
Name	:	MARYANN OBI
Credential	:
Telephone Number	:	915-581-6313

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	06/17/2008

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