Ambassador for Home,LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

AMBASSADOR FOR HOME,LLC

Doing business as

BrightStar Care of W. Montgomery Co.

Practice address

2939 W Germantown Pike Ste a
Eagleville, PA 19403-1062

Phone

(484) 685-5100

Fax

(484) 685-5107

NPI assigned

Jan 14, 2019

Last updated

Dec 16, 2021By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Ransom

Title

Owner

Phone

(610) 662-0697

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• BrightStar Care of W. Montgomery Co. Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639612800000",
    "number": "1962976829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2939 W GERMANTOWN PIKE STE A",
            "city": "EAGLEVILLE",
            "state": "PA",
            "postal_code": "194031062",
            "telephone_number": "484-685-5100",
            "fax_number": "484-685-5107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2939 W GERMANTOWN PIKE STE A",
            "city": "EAGLEVILLE",
            "state": "PA",
            "postal_code": "194031062",
            "telephone_number": "484-685-5100",
            "fax_number": "484-685-5107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBASSADOR FOR HOME,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-14",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A",
        "authorized_official_last_name": "RANSOM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-662-0697"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103747226-0001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BrightStar Care of W. Montgomery Co.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.