MEDICARE: ABOVE 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

General Provider Information

NPI Number	:	1366199531
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABOVE HEALTHCARE SERVICES LLC

Provider Business Mailing Address
First Line	:	22 14TH ST NW UNIT 3305
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-4717
Country	:	US
Telephone Number	:	404-804-5638
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 14TH ST NW UNIT 3305
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-4717
Country	:	US
Telephone Number	:	404-804-5638
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. RICKY ANDREWS JR.
Credential	:
Telephone Number	:	404-804-5638

Provider Enumeration Date	:	03/07/2022
Last Update Date	:	03/07/2022

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