MEDICARE: NORTH STAR HOME HEALTH SERVICES, 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	013506	TX
2	251E00000X	Home Health Agency	009213	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891901997
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH STAR HOME HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	1340 PRUDENTIAL DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-4115
Country	:	US
Telephone Number	:	214-275-4667
Fax Number	:	214-275-5273

Provider Business Practice Location Address
First Line	:	1340 PRUDENTIAL DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-4115
Country	:	US
Telephone Number	:	214-275-4667
Fax Number	:	214-275-5273

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	SUSIE MATHEW
Credential	:	RN
Telephone Number	:	214-275-4667

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	04/26/2012

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Directions to “NORTH STAR HOME HEALTH SERVICES, INC. ” Practice Location

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