MEDICARE: A & AMAZING HOME CARE 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	3747P1801X	Personal Care Attendant

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	:	1881842474
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A & AMAZING HOME CARE LLC

Provider Business Mailing Address
First Line	:	4112 SAN PEDRO AVE
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-1834
Country	:	US
Telephone Number	:	210-979-6022
Fax Number	:	210-979-6025

Provider Business Practice Location Address
First Line	:	4112 SAN PEDRO AVE
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-1834
Country	:	US
Telephone Number	:	210-979-6022
Fax Number	:	210-979-6025

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	MRS. IRMA VINTON
Credential	:
Telephone Number	:	210-979-6022

Provider Enumeration Date	:	09/08/2008
Last Update Date	:	01/12/2022

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