MEDICARE: THE FONTENAY MERCY HOME HEALTH CARE 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	171W00000X	Contractor	801568189	TX

General Provider Information

NPI Number	:	1710253729
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE FONTENAY MERCY HOME HEALTH CARE INC.

Provider Business Mailing Address
First Line	:	3307 FONTENAY PARK
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-4740
Country	:	US
Telephone Number	:	210-749-7898
Fax Number	:

Provider Business Practice Location Address
First Line	:	3307 FONTENAY PARK
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-4740
Country	:	US
Telephone Number	:	210-749-7898
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARIA ELIZABETH PASCUAL CARRILLO
Credential	:
Telephone Number	:	210-749-7898

Provider Enumeration Date	:	03/24/2012
Last Update Date	:	03/24/2012

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