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NPI Code Detail

MEDICARE: FULFORD HOME HEALTH, LLC

MEDICARE: FULFORD HOME HEALTH, 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
1251E00000XHome Health Agency015073TX

General Provider Information

NPI Number : 1861776379
Entity Type Code : Organization
Provider Name (Legal Business Name) : FULFORD HOME HEALTH, LLC
Provider Business Mailing Address
First Line : 1506 W PIONEER PKWY STE 206
Second Line :
City : ARLINGTON
State : TX
Zip : 76013-6200
Country : US
Telephone Number : 817-542-0077
Fax Number : 817-542-0099
Provider Business Practice Location Address
First Line : 1506 W PIONEER PKWY STE 206
Second Line :
City : ARLINGTON
State : TX
Zip : 76013-6200
Country : US
Telephone Number : 817-542-0077
Fax Number : 817-542-0099
Authorized Official
Title or Position : ADMINISTRATOR/DON
Name : SYLVIA SANYU K. KELONYE MUSASIA
Credential :
Telephone Number : 817-542-0077
Provider Enumeration Date : 10/03/2011
Last Update Date : 01/25/2018

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Directions to “FULFORD HOME HEALTH, LLC ” Practice Location

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