Healthcare Provider Details

I. General information

NPI: 1548155633
Provider Name (Legal Business Name): AMELICARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2025
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HIGHLAND COLONY PKWY STE 5203
RIDGELAND MS
39157-2079
US

IV. Provider business mailing address

12004 JOURNEYS END TRL
HUNTERSVILLE NC
28078-2387
US

V. Phone/Fax

Practice location:
  • Phone: 980-483-7745
  • Fax:
Mailing address:
  • Phone: 980-483-7745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHANEQUA CAMPBELL
Title or Position: ADMINISTRATOR
Credential:
Phone: 662-438-2099