Individual ProviderAndrew AmbroseDentistDental ProvidersPractice Address200 Doctors Dr, Suite A, Jacksonville, NC 28546-6310(910) 353-5171PECOS EnrollmentBased on the most recent information from CMS, provider Andrew Ambrose is legally eligible to order and refer claims for Part B, HHA and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:51 AM.Profile DetailsProvider ID1639584345Provider TypeIndividualFull NameAmbrose, AndrewGenderMaleSole ProprietorYesEnumeration Date6/23/2014Last Updated6/23/2014Contact InformationPractice LocationPractice Address200 Doctors Dr, Suite A, Jacksonville, NC 28546-6310Phone(910) 353-5171Fax(910) 353-8810Mailing LocationMailing Address200 Doctors Dr, Suite A, Jacksonville, NC 28546-6310Phone(910) 353-5171Fax(910) 353-8810Provider TaxonomiesCodeDescriptionLicenseCode1223G0001XPrimaryDescriptionDentistDental ProvidersLicense9795North Carolina