MEDICARE: WOODLANDS HEALTH GROUP, PLLC

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1811537699
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOODLANDS HEALTH GROUP, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 772181
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48277-2181
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	24624 INTERSTATE 45 N STE 125
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-4084
Country	:	US
Telephone Number	:	832-688-6111
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN J RUSH
Credential	:
Telephone Number	:	301-928-1697

Provider Enumeration Date	:	01/09/2020
Last Update Date	:	01/09/2020

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