MEDICARE: ASSURANCE HOME AND CONVALESCENT CARE

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	163WH0200X	Home Health Registered Nurse

General Provider Information

NPI Number	:	1558516567
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSURANCE HOME AND CONVALESCENT CARE

Provider Business Mailing Address
First Line	:	451 BAXTER AVENUE
Second Line	:	SUITE 105
City	:	LOUISVILLE
State	:	KY
Zip	:	40204-1177
Country	:	US
Telephone Number	:	502-540-5240
Fax Number	:	502-540-5285

Provider Business Practice Location Address
First Line	:	451 BAXTER AVENUE
Second Line	:	SUITE 105
City	:	LOUISVILLE
State	:	KY
Zip	:	40204-1177
Country	:	US
Telephone Number	:	502-540-5240
Fax Number	:	502-540-5285

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. ANNE COOPER DAY
Credential	:
Telephone Number	:	502-540-5240

Provider Enumeration Date	:	11/19/2008
Last Update Date	:	11/19/2008

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