=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366029407
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | A.M.POOLE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/25/2021
-----------------------------------------------------
Last Update Date | 03/25/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4 LOGAN LN
-----------------------------------------------------
City | WESTON
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06883-1444
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-446-4526
-----------------------------------------------------
Fax | 203-222-7489
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4 LOGAN LN
-----------------------------------------------------
City | WESTON
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06883-1444
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-446-4526
-----------------------------------------------------
Fax | 203-222-7489
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | ANNE MARIE POOLE
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 201-446-4526
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------