Provider Demographics
NPI:1417674490
Name:AMBEMAA HOMECARE LLC
Entity Type:Organization
Organization Name:AMBEMAA HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER ADMIN
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:973-462-4429
Mailing Address - Street 1:12 WHITETHORN LN
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-5676
Mailing Address - Country:US
Mailing Address - Phone:973-462-4429
Mailing Address - Fax:864-671-0301
Practice Address - Street 1:100 BUSINESS PKWY # A-D
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:SC
Practice Address - Zip Code:29673-6707
Practice Address - Country:US
Practice Address - Phone:973-462-4429
Practice Address - Fax:864-671-0301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care