MEDICARE: NEWCHANNEL INCORPORATED

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	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	0065451	TX
2	251E00000X	Home Health Agency	009419	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790783819
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEWCHANNEL INCORPORATED

Provider Business Mailing Address
First Line	:	PO BOX 36932
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77236-6932
Country	:	US
Telephone Number	:	713-668-4141
Fax Number	:	713-668-4142

Provider Business Practice Location Address
First Line	:	2646 S LOOP W
Second Line	:	SUITE 270 & 270A
City	:	HOUSTON
State	:	TX
Zip	:	77054-2665
Country	:	US
Telephone Number	:	713-668-4141
Fax Number	:	713-668-4142

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. OKECHUKWU OGBUJI
Credential	:
Telephone Number	:	832-242-7007

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	12/15/2008

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Directions to “NEWCHANNEL INCORPORATED ” Practice Location

Language	Start Address	Practice Location

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