MEDICARE: MULTIMED II 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	15750	TX

General Provider Information

NPI Number	:	1982601415
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MULTIMED II LLC

Provider Business Mailing Address
First Line	:	1232 FM 646 RD W
Second Line	:
City	:	DICKINSON
State	:	TX
Zip	:	77539-3017
Country	:	US
Telephone Number	:	281-557-0102
Fax Number	:	281-557-0906

Provider Business Practice Location Address
First Line	:	1232 FM 646 RD W
Second Line	:
City	:	DICKINSON
State	:	TX
Zip	:	77539-3017
Country	:	US
Telephone Number	:	281-557-0102
Fax Number	:	281-557-0906

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. CAROL LAZENBERRY
Credential	:
Telephone Number	:	281-557-0102

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	07/09/2015

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