MEDICARE: CONCORD 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	332B00000X	Durable Medical Equipment & Medical Supplies	005170	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

General Provider Information

NPI Number	:	1992855266
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONCORD HOME CARE INC

Provider Business Mailing Address
First Line	:	303 W SUNSET RD
Second Line	:	SUITE 200
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-1749
Country	:	US
Telephone Number	:	210-731-8996
Fax Number	:	210-731-8895

Provider Business Practice Location Address
First Line	:	303 W SUNSET RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-1749
Country	:	US
Telephone Number	:	210-822-9507
Fax Number	:	210-822-9564

Authorized Official
Title or Position	:	CEO
Name	:	MS. IFEOMA JACQUELINE OKOLO
Credential	:	RN
Telephone Number	:	210-731-8996

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	10/20/2010

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Directions to “CONCORD HOME CARE INC ” Practice Location

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