MEDICARE: AMBASSADORS HOME CARE 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	3747P1801X	Personal Care Attendant	HC3088	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	:	1558482463
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMBASSADORS HOME CARE SERVICES, INC

Provider Business Mailing Address
First Line	:	PO BOX 27177
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28314-5036
Country	:	US
Telephone Number	:	910-920-2520
Fax Number	:	910-920-2806

Provider Business Practice Location Address
First Line	:	1104 HOPE MILLS RD
Second Line	:	SUITE B
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-4247
Country	:	US
Telephone Number	:	910-920-2520
Fax Number	:	910-920-2806

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. KATHY ANN POWELL
Credential	:
Telephone Number	:	910-920-2520

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	01/06/2011

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