Provider Demographics
NPI:1689891566
Name:FORTUNE HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:FORTUNE HOME HEALTH CARE INC
Other - Org Name:FORTUNE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:S
Authorized Official - Last Name:OKPUZOR
Authorized Official - Suffix:
Authorized Official - Credentials:NA
Authorized Official - Phone:281-265-2643
Mailing Address - Street 1:12808 WEST AIRPORT
Mailing Address - Street 2:STE 222
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478
Mailing Address - Country:US
Mailing Address - Phone:281-265-2643
Mailing Address - Fax:281-265-3941
Practice Address - Street 1:12808 WEST AIRPORT
Practice Address - Street 2:STE 222
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478
Practice Address - Country:US
Practice Address - Phone:281-265-2643
Practice Address - Fax:281-265-3941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011182251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001017004Medicaid
TX679792Medicare Oscar/Certification
679792Medicare Oscar/Certification