MEDICARE: AMERICAN HEALTHCARE PCA LLC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1699131052
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN HEALTHCARE PCA LLC

Provider Business Mailing Address
First Line	:	45 LYMAN ST STE 26
Second Line	:
City	:	WESTBOROUGH
State	:	MA
Zip	:	01581-2658
Country	:	US
Telephone Number	:	508-414-8556
Fax Number	:

Provider Business Practice Location Address
First Line	:	45 LYMAN ST STE 26
Second Line	:
City	:	WESTBOROUGH
State	:	MA
Zip	:	01581-2658
Country	:	US
Telephone Number	:	508-414-8556
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR/OWNER
Name	:	DAXA PATEL
Credential	:
Telephone Number	:	508-414-8556

Provider Enumeration Date	:	01/14/2016
Last Update Date	:	09/18/2018

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