MEDICARE: CARE ON THE GO

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	704199	TX

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	:	1730599556
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE ON THE GO

Provider Business Mailing Address
First Line	:	PO BOX 19096
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76119-1096
Country	:	US
Telephone Number	:	817-706-8415
Fax Number	:

Provider Business Practice Location Address
First Line	:	4300 PECOS ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76119-5162
Country	:	US
Telephone Number	:	817-706-8415
Fax Number	:

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	MS. AMEISHA JASHON SCOTT
Credential	:	RN, FNP-C
Telephone Number	:	817-706-8415

Provider Enumeration Date	:	05/01/2014
Last Update Date	:	05/01/2014

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Directions to “CARE ON THE GO ” Practice Location

Language	Start Address	Practice Location

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