MEDICARE: FALCON HEALTHCARE 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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1861626640
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FALCON HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	2546 W MEDFORD AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53206-1025
Country	:	US
Telephone Number	:	414-702-5684
Fax Number	:	414-264-1143

Provider Business Practice Location Address
First Line	:	2546 W MEDFORD AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53206-1025
Country	:	US
Telephone Number	:	414-702-5684
Fax Number	:	414-264-1143

Authorized Official
Title or Position	:	OWNER
Name	:	MS. PEARLINE WILLIAMS
Credential	:
Telephone Number	:	414-702-5684

Provider Enumeration Date	:	05/08/2009
Last Update Date	:	05/08/2009

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