MEDICARE: AGELESS AUBURN, 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1750230801
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGELESS AUBURN, LLC

Provider Business Mailing Address
First Line	:	576 HAMILTON HILLS CT
Second Line	:
City	:	AUBURN
State	:	AL
Zip	:	36830-7568
Country	:	US
Telephone Number	:	334-444-4214
Fax Number	:

Provider Business Practice Location Address
First Line	:	576 HAMILTON HILLS CT
Second Line	:
City	:	AUBURN
State	:	AL
Zip	:	36830-7568
Country	:	US
Telephone Number	:	334-444-4214
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RICHARD SCOTT
Credential	:
Telephone Number	:	334-444-4214

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

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