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NPI Code Detail

MEDICARE: JOD HOME HEALTH CARE SERVICE LLC

MEDICARE: JOD HOME HEALTH CARE SERVICE LLC
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
1302R00000XHealth Maintenance OrganizationRN LIC. NO 753086TX

General Provider Information

NPI Number : 1851550594
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOD HOME HEALTH CARE SERVICE LLC
Provider Business Mailing Address
First Line : 1506 WHITE WILLOW LN
Second Line :
City : ARLINGTON
State : TX
Zip : 76002-4624
Country : US
Telephone Number : 817-784-6252
Fax Number :
Provider Business Practice Location Address
First Line : 1506 WHITE WILLOW LN
Second Line :
City : ARLINGTON
State : TX
Zip : 76002-4624
Country : US
Telephone Number : 817-784-6252
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR.
Name : MR. OLUWAROTIMI OLANREWAJU ODUBANJO
Credential :
Telephone Number : 817-784-6252
Provider Enumeration Date : 06/07/2008
Last Update Date : 06/07/2008

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Directions to “JOD HOME HEALTH CARE SERVICE LLC ” Practice Location

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