Provider Demographics
NPI:1194193219
Name:AMAZINE HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:AMAZINE HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:3146-533-2554
Mailing Address - Street 1:5388 BAYHAMABBY RD
Mailing Address - Street 2:
Mailing Address - City:BLACK JACK
Mailing Address - State:MO
Mailing Address - Zip Code:63033-7302
Mailing Address - Country:US
Mailing Address - Phone:314-653-3255
Mailing Address - Fax:
Practice Address - Street 1:5388 BAYHAMABBY RD
Practice Address - Street 2:
Practice Address - City:BLACK JACK
Practice Address - State:MO
Practice Address - Zip Code:63033-7302
Practice Address - Country:US
Practice Address - Phone:314-653-3255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-05
Last Update Date:2015-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health