=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639442189
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AB CAREGIVING AND HOME NURSING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/14/2012
-----------------------------------------------------
Last Update Date | 02/14/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 814 E PARK AVE
-----------------------------------------------------
City | ANACONDA
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59711-2563
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-563-5031
-----------------------------------------------------
Fax | 406-563-5031
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 814 E PARK AVE
-----------------------------------------------------
City | ANACONDA
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59711-2563
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-563-5031
-----------------------------------------------------
Fax | 406-563-5031
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CO-OWNER
-----------------------------------------------------
Name | MS. ANNE M ASPHOLM
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 406-563-5031
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | RN27537
-----------------------------------------------------
License Number State | MT
-----------------------------------------------------