MEDICARE: EDSY HOME CARE

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1508534082
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDSY HOME CARE

Provider Business Mailing Address
First Line	:	1454 S QUEBEC WAY
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-2602
Country	:	US
Telephone Number	:	720-999-4297
Fax Number	:

Provider Business Practice Location Address
First Line	:	1454 S QUEBEC WAY
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-2602
Country	:	US
Telephone Number	:	720-999-4297
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DAVY PRARK
Credential	:
Telephone Number	:	720-999-4297

Provider Enumeration Date	:	08/31/2021
Last Update Date	:	08/31/2021

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Directions to “EDSY HOME CARE ” Practice Location

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