MEDICARE: AVERY PARTNERS, 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

General Provider Information

NPI Number	:	1962899054
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVERY PARTNERS, INC

Provider Business Mailing Address
First Line	:	1455 OLD ALABAMA RD
Second Line	:	STE 160
City	:	ROSWELL
State	:	GA
Zip	:	30076-2129
Country	:	US
Telephone Number	:	770-642-6100
Fax Number	:	678-367-4603

Provider Business Practice Location Address
First Line	:	7323 BOULDER VIEW LN
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23225-4953
Country	:	US
Telephone Number	:	804-745-0054
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. JEFF MOORE
Credential	:
Telephone Number	:	770-639-5809

Provider Enumeration Date	:	04/16/2015
Last Update Date	:	07/31/2015

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