MEDICARE: REASSURANCE HOME HEALTH AIDE

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	311ZA0620X	Adult Care Home Facility	406971	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

General Provider Information

NPI Number	:	1417386103
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REASSURANCE HOME HEALTH AIDE

Provider Business Mailing Address
First Line	:	4510 CHRISTENBURY HILLS LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-0980
Country	:	US
Telephone Number	:	704-904-6246
Fax Number	:

Provider Business Practice Location Address
First Line	:	4510 CHRISTENBURY HILLS LN
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-0980
Country	:	US
Telephone Number	:	704-904-6246
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NATALIE A FREDERICK
Credential	:	CNA
Telephone Number	:	704-904-6246

Provider Enumeration Date	:	11/04/2013
Last Update Date	:	11/04/2013

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Directions to “REASSURANCE HOME HEALTH AIDE ” Practice Location

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