=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174995476
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMERICAN HOME HEALTHCARE SOLUTIONS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/26/2015
-----------------------------------------------------
Last Update Date | 05/25/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11905 MAIN ST
-----------------------------------------------------
City | FREDERICKSBURG
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22408-7326
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-207-9287
-----------------------------------------------------
Fax | 540-656-2667
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11905 MAIN ST
-----------------------------------------------------
City | FREDERICKSBURG
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22408-7326
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-207-9287
-----------------------------------------------------
Fax | 540-656-2667
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/ADMINISTRATOR
-----------------------------------------------------
Name | MR. MAWIA BAKRI MOHAMED
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 540-207-9284
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | HCO161298
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------