MEDICARE: F & C HOME CARE SERVICE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1992931398
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	F & C HOME CARE SERVICE LLC

Provider Business Mailing Address
First Line	:	4200 N PEBBLE CREEK PKWY APT 2039
Second Line	:
City	:	GOODYEAR
State	:	AZ
Zip	:	85395-9026
Country	:	US
Telephone Number	:	623-523-4113
Fax Number	:

Provider Business Practice Location Address
First Line	:	4200 N PEBBLE CREEK PKWY APT 2039
Second Line	:
City	:	GOODYEAR
State	:	AZ
Zip	:	85395-9026
Country	:	US
Telephone Number	:	623-523-4113
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	CYNTHIA ESHUN
Credential	:
Telephone Number	:	623-523-4113

Provider Enumeration Date	:	05/31/2009
Last Update Date	:	05/31/2009

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