MEDICARE: AMELIA HOME CARE 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	:	1679172100
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMELIA HOME CARE INC.

Provider Business Mailing Address
First Line	:	3007 OCEAN PKWY APT 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-8053
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3007 OCEAN PKWY APT 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-8053
Country	:	US
Telephone Number	:	929-333-3955
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANTHONY TROCHTCHENKOV
Credential	:
Telephone Number	:	929-333-3955

Provider Enumeration Date	:	10/26/2020
Last Update Date	:	10/26/2020

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