MEDICARE: AVENTURA AT SHILOH SPRINGS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1235902347
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AVENTURA AT SHILOH SPRINGS LLC

Provider Business Mailing Address
First Line	:	3500 SHILOH SPRINGS RD
Second Line	:
City	:	TROTWOOD
State	:	OH
Zip	:	45426-2260
Country	:	US
Telephone Number	:	937-854-1180
Fax Number	:

Provider Business Practice Location Address
First Line	:	3500 SHILOH SPRINGS RD
Second Line	:
City	:	TROTWOOD
State	:	OH
Zip	:	45426-2260
Country	:	US
Telephone Number	:	937-854-1180
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	MOISHE KASZIRER
Credential	:
Telephone Number	:	610-686-3300

Provider Enumeration Date	:	10/31/2023
Last Update Date	:	10/31/2023

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