MEDICARE: J.D. AHREN HOME HEALTHCARE ADVANTAGE

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	R2705	MD

General Provider Information

NPI Number	:	1821239013
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J.D. AHREN HOME HEALTHCARE ADVANTAGE

Provider Business Mailing Address
First Line	:	914 LAKE FRONT DR
Second Line	:
City	:	MITCHELLVILLE
State	:	MD
Zip	:	20721-2950
Country	:	US
Telephone Number	:	301-379-2008
Fax Number	:

Provider Business Practice Location Address
First Line	:	914 LAKE FRONT DR
Second Line	:
City	:	MITCHELLVILLE
State	:	MD
Zip	:	20721-2950
Country	:	US
Telephone Number	:	301-379-2008
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. PAULETTE R RAMSAY
Credential	:	R.N.
Telephone Number	:	301-379-2008

Provider Enumeration Date	:	03/17/2009
Last Update Date	:	03/17/2009

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