MEDICARE: COLUMBUS ASHLEY JR.

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

General Provider Information

NPI Number	:	1750219887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLUMBUS ASHLEY JR.

Provider Business Mailing Address
First Line	:	26716 OSMUN ST
Second Line	:
City	:	MADISON HEIGHTS
State	:	MI
Zip	:	48071-3762
Country	:	US
Telephone Number	:	904-480-6640
Fax Number	:

Provider Business Practice Location Address
First Line	:	26716 OSMUN ST
Second Line	:
City	:	MADISON HEIGHTS
State	:	MI
Zip	:	48071-3762
Country	:	US
Telephone Number	:	904-480-6640
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/11/2026

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