MEDICARE: VIKEM HOME & HEALTH SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	311ZA0620X	Adult Care Home Facility
2	313M00000X	Nursing Facility/Intermediate Care Facility
3	3140N1450X	Pediatric Skilled Nursing Facility
4	332B00000X	Durable Medical Equipment & Medical Supplies
5	332BN1400X	Nursing Facility Supplies (DME)
6	3416L0300X	Land Ambulance
7	343900000X	Non-emergency Medical Transport (VAN)
8	347C00000X	Private Vehicle
9	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	23	OTHER	TX	TEXAS DEPARTMENT OF AGING AND DISABILITY SERVICES

General Provider Information

NPI Number	:	1790013019
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIKEM HOME & HEALTH SERVICES

Provider Business Mailing Address
First Line	:	PO BOX 450444
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77245-0444
Country	:	US
Telephone Number	:	972-422-1436
Fax Number	:	972-200-5042

Provider Business Practice Location Address
First Line	:	4507 TWIN ELM DR
Second Line	:
City	:	FRESNO
State	:	TX
Zip	:	77545-9535
Country	:	US
Telephone Number	:	972-422-1436
Fax Number	:	972-200-5042

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	MR. JUDE OKEZIE EJIMAKOR
Credential	:
Telephone Number	:	972-422-1436

Provider Enumeration Date	:	11/24/2009
Last Update Date	:	11/24/2009

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Directions to “VIKEM HOME & HEALTH SERVICES ” Practice Location

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