MEDICARE: ELDERCARE SERVICES 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	385H00000X	Respite Care

General Provider Information

NPI Number	:	1447511647
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELDERCARE SERVICES INC.

Provider Business Mailing Address
First Line	:	7976 NASHVILLE HWY
Second Line	:
City	:	BAXTER
State	:	TN
Zip	:	38544-3810
Country	:	US
Telephone Number	:	305-240-0599
Fax Number	:	800-621-0350

Provider Business Practice Location Address
First Line	:	7976 NASHVILLE HWY
Second Line	:
City	:	BAXTER
State	:	TN
Zip	:	38544-3810
Country	:	US
Telephone Number	:	305-240-0599
Fax Number	:	800-621-0350

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEPHANIE PETERSON
Credential	:
Telephone Number	:	305-240-0599

Provider Enumeration Date	:	06/04/2012
Last Update Date	:	06/04/2012

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Directions to “ELDERCARE SERVICES INC. ” Practice Location

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