MEDICARE: GLOBAL HOME CARE, 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	314000000X	Skilled Nursing Facility	R878106	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12115	OTHER	MS	VETERANS ADMINISTRATATION

General Provider Information

NPI Number	:	1679819890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLOBAL HOME CARE, LLC

Provider Business Mailing Address
First Line	:	558 CREEKSIDE DR
Second Line	:	205
City	:	LOWELL
State	:	IN
Zip	:	46356-7921
Country	:	US
Telephone Number	:	318-331-3619
Fax Number	:	219-690-3343

Provider Business Practice Location Address
First Line	:	4213 PRUITT RD
Second Line	:
City	:	WEST POINT
State	:	MS
Zip	:	39773-4517
Country	:	US
Telephone Number	:	318-331-3619
Fax Number	:	219-690-3343

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. EDNA J COLLINS
Credential	:	DIRECTOR
Telephone Number	:	318-331-3619

Provider Enumeration Date	:	12/14/2012
Last Update Date	:	06/28/2013

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