MEDICARE: ABLE HEALTHCARE 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	251E00000X	Home Health Agency	9315	NY

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962404913
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABLE HEALTHCARE SERVICE, INC.

Provider Business Mailing Address
First Line	:	1240 BROADCAST PLZ
Second Line	:
City	:	MERRICK
State	:	NY
Zip	:	11566-3461
Country	:	US
Telephone Number	:	516-546-8000
Fax Number	:	516-546-2360

Provider Business Practice Location Address
First Line	:	1240 BROADCAST PLZ
Second Line	:
City	:	MERRICK
State	:	NY
Zip	:	11566-3461
Country	:	US
Telephone Number	:	516-546-8000
Fax Number	:	516-546-2360

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MICHAEL SHAPIRO
Credential	:
Telephone Number	:	516-546-8000

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	04/27/2009

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