MEDICARE: ABIDE INFUSIONS AND HOME 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	251E00000X	Home Health Agency
2	251F00000X	Home Infusion Agency

General Provider Information

NPI Number	:	1669092391
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABIDE INFUSIONS AND HOME CARE

Provider Business Mailing Address
First Line	:	741 PIEDMONT AVE NE STE 130
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30308-1420
Country	:	US
Telephone Number	:	614-219-9825
Fax Number	:

Provider Business Practice Location Address
First Line	:	741 PIEDMONT AVE NE STE 130
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30308-1420
Country	:	US
Telephone Number	:	614-219-9825
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	IKECHUKWU OBIENU
Credential	:
Telephone Number	:	678-531-1094

Provider Enumeration Date	:	04/22/2020
Last Update Date	:	06/19/2020

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