MEDICARE: AMERICAS SUPPORTS COORDINATION AND MANAGEMENT

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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1104184373
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAS SUPPORTS COORDINATION AND MANAGEMENT

Provider Business Mailing Address
First Line	:	7942 BUSTLETON AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152-3321
Country	:	US
Telephone Number	:	215-342-2220
Fax Number	:

Provider Business Practice Location Address
First Line	:	7942 BUSTLETON AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19152-3321
Country	:	US
Telephone Number	:	215-342-2220
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER/PRESIDENT
Name	:	MARINA SANADZE
Credential	:
Telephone Number	:	215-342-2220

Provider Enumeration Date	:	04/25/2012
Last Update Date	:	04/25/2012

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