MEDICARE: JED'S HEALTH CARE 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	009860	TX

General Provider Information

NPI Number	:	1770520561
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JED'S HEALTH CARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	2470 GRAY FALLS DR STE 140
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-6535
Country	:	US
Telephone Number	:	281-240-1174
Fax Number	:	281-240-1103

Provider Business Practice Location Address
First Line	:	2470 GRAY FALLS DR STE 140
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-6535
Country	:	US
Telephone Number	:	281-240-1174
Fax Number	:	281-240-1103

Authorized Official
Title or Position	:	OWNER
Name	:	MR. MUSTAFA KAIS ARIF ALSUWAIDI
Credential	:
Telephone Number	:	281-240-1174

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	03/07/2019

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