MEDICARE: ACCEPTANCE HEALTH SERVICE INC.

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	111737	GA

General Provider Information

NPI Number	:	1831430388
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCEPTANCE HEALTH SERVICE INC.

Provider Business Mailing Address
First Line	:	1224 PEACOCK AVE STE 100B
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31906-6013
Country	:	US
Telephone Number	:	706-321-7150
Fax Number	:	706-321-7151

Provider Business Practice Location Address
First Line	:	1224 PEACOCK AVE STE 100B
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31906-6013
Country	:	US
Telephone Number	:	706-321-7150
Fax Number	:	706-321-7151

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JIMMY DEWAYNE KIMBROUGH
Credential	:
Telephone Number	:	706-321-7150

Provider Enumeration Date	:	03/08/2013
Last Update Date	:	03/08/2013

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