MEDICARE: OUR HOMECARE,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	011578	TX

General Provider Information

NPI Number	:	1861563173
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OUR HOMECARE,INC

Provider Business Mailing Address
First Line	:	2636 WALNUT HILL LN STE 201
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75229-4554
Country	:	US
Telephone Number	:	214-350-4033
Fax Number	:	214-350-4689

Provider Business Practice Location Address
First Line	:	2636 WALNUT HILL LN STE 201
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75229-4554
Country	:	US
Telephone Number	:	214-350-4033
Fax Number	:	214-350-4689

Authorized Official
Title or Position	:	CFO
Name	:	MR. RICHARD NANA NKWANWO
Credential	:
Telephone Number	:	214-350-4033

Provider Enumeration Date	:	11/10/2006
Last Update Date	:	10/18/2007

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