MEDICARE: AMAZON HEALTHCARE SERVICES, 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		TX

General Provider Information

NPI Number	:	1205317336
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMAZON HEALTHCARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	8506 ATWOOD BEND TRL
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-2522
Country	:	US
Telephone Number	:	832-955-5418
Fax Number	:

Provider Business Practice Location Address
First Line	:	8506 ATWOOD BEND TRL
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-2522
Country	:	US
Telephone Number	:	832-955-5418
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MARIA ELECHI
Credential	:
Telephone Number	:	832-955-5418

Provider Enumeration Date	:	08/27/2018
Last Update Date	:	08/27/2018

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