MEDICARE: AT HOME CARE INCORPORATED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	3824601	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003819806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AT HOME CARE INCORPORATED

Provider Business Mailing Address
First Line	:	1 FOXCARE DR STE 102
Second Line	:
City	:	ONEONTA
State	:	NY
Zip	:	13820-2681
Country	:	US
Telephone Number	:	607-432-7924
Fax Number	:	607-432-7927

Provider Business Practice Location Address
First Line	:	1 FOXCARE DR STE 102
Second Line	:
City	:	ONEONTA
State	:	NY
Zip	:	13820-2681
Country	:	US
Telephone Number	:	607-432-7924
Fax Number	:	607-432-7927

Authorized Official
Title or Position	:	DIRECTOR OF HOME CARE SERVICES
Name	:	JEREMY PAIN
Credential	:
Telephone Number	:	607-432-7924

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	12/19/2022

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1356297055 — MARISHA IRISH
Practice Location Address:

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1922000116 — DR. JORDAN M TANNENBAUM M.D.
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Directions to “AT HOME CARE INCORPORATED ” Practice Location

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