=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477216968
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MACY HOMECARE SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/21/2021
-----------------------------------------------------
Last Update Date | 10/21/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8101 SANDY SPRING RD
-----------------------------------------------------
City | LAUREL
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20707-3596
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-870-6477
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14502 GREENVIEW DR STE L18
-----------------------------------------------------
City | LAUREL
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20708-3287
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-870-6477
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CONSULTANT
-----------------------------------------------------
Name | DOROTHY I FELIX
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 240-870-6477
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------