MEDICARE: ANCHORED HEARTS HEALTH SERVICES, 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1982260949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANCHORED HEARTS HEALTH SERVICES, LLC

Provider Business Mailing Address
First Line	:	1021 FRANKLIN AVE
Second Line	:
City	:	LEXINGTON
State	:	MO
Zip	:	64067-1333
Country	:	US
Telephone Number	:	660-251-2110
Fax Number	:	660-251-2112

Provider Business Practice Location Address
First Line	:	1021 FRANKLIN AVE
Second Line	:
City	:	LEXINGTON
State	:	MO
Zip	:	64067-1333
Country	:	US
Telephone Number	:	660-251-2110
Fax Number	:	660-251-2112

Authorized Official
Title or Position	:	MEMBER
Name	:	MRS. PAMELA DOTHAGE
Credential	:
Telephone Number	:	660-232-2085

Provider Enumeration Date	:	05/15/2019
Last Update Date	:	05/15/2019

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