MEDICARE: CARDIOVASCULAR HOME CARE, 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	002934	TX

General Provider Information

NPI Number	:	1891798963
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIOVASCULAR HOME CARE, INC.

Provider Business Mailing Address
First Line	:	2501 PARKVIEW DR
Second Line	:	STE 426
City	:	FORT WORTH
State	:	TX
Zip	:	76102-5815
Country	:	US
Telephone Number	:	817-847-8888
Fax Number	:	817-847-1884

Provider Business Practice Location Address
First Line	:	2501 PARKVIEW DR
Second Line	:	STE 426
City	:	FORT WORTH
State	:	TX
Zip	:	76102-5815
Country	:	US
Telephone Number	:	817-847-8888
Fax Number	:	817-847-1884

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. BRIDGETTE CAMPBELL
Credential	:	RN
Telephone Number	:	817-847-8888

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	01/06/2014

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