Provider Demographics
NPI:1962531194
Name:HEALTHMASTERS HOMECARE, INC
Entity type:Organization
Organization Name:HEALTHMASTERS HOMECARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:J
Authorized Official - Last Name:WICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CHTP
Authorized Official - Phone:817-927-9550
Mailing Address - Street 1:2932 HEMPHILL ST
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76110-6501
Mailing Address - Country:US
Mailing Address - Phone:817-927-9550
Mailing Address - Fax:817-927-9558
Practice Address - Street 1:2932 HEMPHILL ST
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76110-6501
Practice Address - Country:US
Practice Address - Phone:817-927-9550
Practice Address - Fax:817-927-9558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007753251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
679041Medicare Oscar/Certification