MEDICARE: AGE MARKETING, INC.

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	HC2564	NC

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134266851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGE MARKETING, INC.

Provider Business Mailing Address
First Line	:	PO BOX 4062
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27404-4062
Country	:	US
Telephone Number	:	336-664-5787
Fax Number	:

Provider Business Practice Location Address
First Line	:	445 DOLLEY MADISON RD STE A
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-5166
Country	:	US
Telephone Number	:	336-664-5787
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. JANE E THOMPSON
Credential	:
Telephone Number	:	336-664-5787

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	01/24/2013

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