MEDICARE: SAMCOS HEALTHCARE SERVICES, INC

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	:	1679866479
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMCOS HEALTHCARE SERVICES, INC

Provider Business Mailing Address
First Line	:	10806 PRIMROSE ACRES LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77031-2748
Country	:	US
Telephone Number	:	713-981-6777
Fax Number	:	713-400-9691

Provider Business Practice Location Address
First Line	:	10806 PRIMROSE ACRES LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77031-2748
Country	:	US
Telephone Number	:	713-981-6777
Fax Number	:	713-400-9691

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. CHIDIEBERE A OBI
Credential	:
Telephone Number	:	713-981-6777

Provider Enumeration Date	:	05/26/2011
Last Update Date	:	05/26/2011

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