MEDICARE: EFW PRIMARY CARE SERVICES

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	:	1588986830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EFW PRIMARY CARE SERVICES

Provider Business Mailing Address
First Line	:	1531 MISTY GLEN LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75232-1535
Country	:	US
Telephone Number	:	214-537-9370
Fax Number	:	214-278-0362

Provider Business Practice Location Address
First Line	:	1531 MISTY GLEN LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75232-1535
Country	:	US
Telephone Number	:	214-537-9370
Fax Number	:	214-278-0362

Authorized Official
Title or Position	:	OWNER
Name	:	WILLIE WOLFORD
Credential	:
Telephone Number	:	214-537-9370

Provider Enumeration Date	:	02/26/2010
Last Update Date	:	02/26/2010

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