Provider Demographics
NPI:1497772289
Name:PILOT POINT HOME HEALTH INC.
Entity Type:Organization
Organization Name:PILOT POINT HOME HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GOEDECKE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:903-564-7709
Mailing Address - Street 1:401 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WHITESBORO
Mailing Address - State:TX
Mailing Address - Zip Code:76273-1805
Mailing Address - Country:US
Mailing Address - Phone:903-564-7709
Mailing Address - Fax:903-564-7090
Practice Address - Street 1:401 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITESBORO
Practice Address - State:TX
Practice Address - Zip Code:76273-1805
Practice Address - Country:US
Practice Address - Phone:903-564-7709
Practice Address - Fax:903-564-7090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX002387251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX677532Medicare ID - Type Unspecified