MEDICARE: ARCHBOLD HEALTH 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	251E00000X	Home Health Agency	043-010	GA

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	:	1588613434
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARCHBOLD HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 3197
Second Line	:
City	:	THOMASVILLE
State	:	GA
Zip	:	31799-3197
Country	:	US
Telephone Number	:	229-246-6462
Fax Number	:	229-246-9959

Provider Business Practice Location Address
First Line	:	117 S DONALSON ST
Second Line	:
City	:	BAINBRIDGE
State	:	GA
Zip	:	39817-5901
Country	:	US
Telephone Number	:	229-246-6462
Fax Number	:	229-246-9959

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. AMY FERRY
Credential	:	RN
Telephone Number	:	229-246-6462

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	06/02/2015

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Directions to “ARCHBOLD HEALTH SERVICES, INC. ” Practice Location

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