MEDICARE: AFFORDABLE INCONTINENCE

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	332B00000X	Durable Medical Equipment & Medical Supplies	20915411	MO

General Provider Information

NPI Number	:	1679841175
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AFFORDABLE INCONTINENCE

Provider Business Mailing Address
First Line	:	205 TUSCARORA LN
Second Line	:
City	:	LAKE WINNEBAGO
State	:	MO
Zip	:	64034-9324
Country	:	US
Telephone Number	:	816-366-0050
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 TUSCARORA LN
Second Line	:
City	:	LAKE WINNEBAGO
State	:	MO
Zip	:	64034-9324
Country	:	US
Telephone Number	:	816-366-0050
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. NATASHA C. BELCHER
Credential	:
Telephone Number	:	816-366-0050

Provider Enumeration Date	:	12/12/2011
Last Update Date	:	12/12/2011

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