MEDICARE: ASHFORD CONSOLIDATED, 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

General Provider Information

NPI Number	:	1538686118
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASHFORD CONSOLIDATED, INC

Provider Business Mailing Address
First Line	:	2586 WOODSIDE RIDGE DR
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32712-6481
Country	:	US
Telephone Number	:	586-291-2279
Fax Number	:	352-577-0399

Provider Business Practice Location Address
First Line	:	428 N. DONNELLY STREET
Second Line	:	SUITE 5
City	:	MOUNT DORA
State	:	FL
Zip	:	32757-5550
Country	:	US
Telephone Number	:	586-291-2279
Fax Number	:	352-577-0399

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DURRAND ASHFORD
Credential	:
Telephone Number	:	586-291-2279

Provider Enumeration Date	:	08/24/2017
Last Update Date	:	06/30/2021

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