Provider Demographics
NPI:1245925197
Name:AMALIFE INC
Entity type:Organization
Organization Name:AMALIFE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GODSON
Authorized Official - Middle Name:
Authorized Official - Last Name:AMAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-318-9533
Mailing Address - Street 1:5237 ALBEMARLE RD STE 221A
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-2603
Mailing Address - Country:US
Mailing Address - Phone:980-318-9533
Mailing Address - Fax:
Practice Address - Street 1:10931 E INDEPENDENCE BLVD
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5056
Practice Address - Country:US
Practice Address - Phone:980-318-9533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health