MEDICARE: BAYSHORE HOME HEALTH LLC

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	:	1598419202
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAYSHORE HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	3328 CHAPEL RIDGE WAY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76116-1229
Country	:	US
Telephone Number	:	817-919-3199
Fax Number	:

Provider Business Practice Location Address
First Line	:	3328 CHAPEL RIDGE WAY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76116-1229
Country	:	US
Telephone Number	:	817-919-3199
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	DORIS BOSIRE
Credential	:
Telephone Number	:	817-919-3199

Provider Enumeration Date	:	02/10/2022
Last Update Date	:	02/22/2023

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Directions to “BAYSHORE HOME HEALTH LLC ” Practice Location

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