MEDICARE: GOLDEN WINGS SITTING SERVICE., LLC.

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

General Provider Information

NPI Number	:	1073203436
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN WINGS SITTING SERVICE., LLC.

Provider Business Mailing Address
First Line	:	23 HOUSTON RD NW
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35215-1159
Country	:	US
Telephone Number	:	205-720-4027
Fax Number	:	205-683-3016

Provider Business Practice Location Address
First Line	:	23 HOUSTON RD NW
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35215-1159
Country	:	US
Telephone Number	:	205-720-4027
Fax Number	:	205-683-3016

Authorized Official
Title or Position	:	OWNER
Name	:	MS. LEISA PREWITT
Credential	:
Telephone Number	:	205-720-4027

Provider Enumeration Date	:	05/09/2023
Last Update Date	:	05/09/2023

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