Provider Demographics
NPI:1598982985
Name:S FISHER & S THOMAS DBA MILLENNIUM HOME CARE OF NE TEXAS
Entity Type:Organization
Organization Name:S FISHER & S THOMAS DBA MILLENNIUM HOME CARE OF NE TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JAYME
Authorized Official - Middle Name:
Authorized Official - Last Name:JETTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:903-784-5556
Mailing Address - Street 1:1010 34TH ST NE
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75462-5319
Mailing Address - Country:US
Mailing Address - Phone:903-784-5556
Mailing Address - Fax:903-784-3444
Practice Address - Street 1:1010 34TH ST NE
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75462-5319
Practice Address - Country:US
Practice Address - Phone:903-784-5556
Practice Address - Fax:903-784-3444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX002797251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX$$$$$$$$$OtherSOCIAL SECURITY NUMBER