Ambie Bergados

Individual provider Active NPI In Home Supportive Care Agency · Baltimore, OH

NPI 1851908578 · NPPES record last updated Sep 27, 2020

Key facts

NPI
1851908578
Entity type
Individual (NPI type 1)
Primary specialty
In Home Supportive Care Agency 253Z00000X
Practice address
11420 Heimberger Rd NW
Baltimore, OH 43105-9461
Phone
(740) 503-8564
NPI assigned
Sep 27, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Yes

Addresses

Primary practice location

11420 Heimberger Rd NW
Baltimore, OH 43105-9461

Mailing address

11420 Heimberger Rd NW
Baltimore, OH 43105-9461
Phone (740) 503-8564

Other identifiers

IdentifierTypeStateIssuer
2304036MedicaidOH

Other providers in Baltimore, OH

All providers in Baltimore, OH · In Home Supportive Care Agency in Ohio

Sources for this page

Verify at the official NPI Registry.