MEDICARE: CARTERS HOME CARE LLC

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	3747P1801X	Personal Care Attendant
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1639880529
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARTERS HOME CARE LLC

Provider Business Mailing Address
First Line	:	6503 ELMHURST ST
Second Line	:
City	:	DISTRICT HEIGHTS
State	:	MD
Zip	:	20747-2228
Country	:	US
Telephone Number	:	240-351-1625
Fax Number	:

Provider Business Practice Location Address
First Line	:	6503 ELMHURST ST
Second Line	:
City	:	DISTRICT HEIGHTS
State	:	MD
Zip	:	20747-2228
Country	:	US
Telephone Number	:	240-351-1625
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	TIFFANY CARTER
Credential	:
Telephone Number	:	240-351-1625

Provider Enumeration Date	:	12/12/2022
Last Update Date	:	12/12/2022

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