MEDICARE: A WHITE CONTRACTOR ENTERPRISES CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	343900000X	Non-emergency Medical Transport (VAN)
3	347C00000X	Private Vehicle
4	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1285412361
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A WHITE CONTRACTOR ENTERPRISES CORPORATION

Provider Business Mailing Address
First Line	:	1403 DUNN AVE STE 2
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-4870
Country	:	US
Telephone Number	:	904-554-8358
Fax Number	:

Provider Business Practice Location Address
First Line	:	6649 RIPPLING WAVE CT
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32244-6876
Country	:	US
Telephone Number	:	904-554-8358
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ASHLEY WHITE
Credential	:
Telephone Number	:	904-554-8358

Provider Enumeration Date	:	09/19/2023
Last Update Date	:	09/19/2023

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Directions to “A WHITE CONTRACTOR ENTERPRISES CORPORATION ” Practice Location

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