MEDICARE: AGLOW HOSPICE CARE SERVICES, 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	163WH1000X	Hospice Registered Nurse

General Provider Information

NPI Number	:	1679169064
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGLOW HOSPICE CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	8016 STONEHILL DR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75025-2564
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8016 STONEHILL DR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75025-2564
Country	:	US
Telephone Number	:	469-702-1948
Fax Number	:

Authorized Official
Title or Position	:	NP
Name	:	CHARLES EBERE OKPARA
Credential	:	FNP-BC
Telephone Number	:	602-909-8026

Provider Enumeration Date	:	12/19/2020
Last Update Date	:	12/19/2020

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