MEDICARE: AMBASSADORS HOME CARE SERVICES, INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	HC3088	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447372743
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMBASSADORS HOME CARE SERVICES, INC

Provider Business Mailing Address
First Line	:	PO BOX 2355
Second Line	:
City	:	LUMBERTON
State	:	NC
Zip	:	28359-2355
Country	:	US
Telephone Number	:	910-272-8038
Fax Number	:	910-272-8039

Provider Business Practice Location Address
First Line	:	204 E 5TH ST
Second Line	:	SUITE 101 & 102
City	:	LUMBERTON
State	:	NC
Zip	:	28358-5576
Country	:	US
Telephone Number	:	910-272-8038
Fax Number	:	910-272-8039

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. KATHY ANN POWLL
Credential	:
Telephone Number	:	910-272-8038

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	08/22/2020

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