Individual ProviderAmy KiatthanapaiboonStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address270 Copperfield Blvd NE Ste 201, Concord, NC 28025-2444(704) 786-6521(704) 721-2060PECOS EnrollmentBased on the most recent information from CMS, provider Amy Kiatthanapaiboon is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1487398640Provider TypeIndividualFull NameKiatthanapaiboon, AmyCredentialDOGenderFemaleSole ProprietorNoEnumeration Date4/25/2022Last Updated4/25/2022Contact InformationPractice LocationPractice Address270 Copperfield Blvd NE Ste 201, Concord, NC 28025-2444Phone(704) 786-6521Fax(704) 782-9703Mailing LocationMailing Address270 Copperfield Blvd NE Ste 202, Concord, NC 28025-2441Phone(704) 721-2060Fax(704) 403-0470Provider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer