MEDICARE: MICHAEL IOANES

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	253Z00000X	In Home Supportive Care Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	518623	OTHER	OH	WAIVER PROVIDER

General Provider Information

NPI Number	:	1326637612
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL IOANES

Provider Business Mailing Address
First Line	:	5909 CARNATION RD
Second Line	:
City	:	WEST CARROLLTON
State	:	OH
Zip	:	45449-2901
Country	:	US
Telephone Number	:	937-286-7603
Fax Number	:

Provider Business Practice Location Address
First Line	:	5909 CARNATION RD
Second Line	:
City	:	WEST CARROLLTON
State	:	OH
Zip	:	45449-2901
Country	:	US
Telephone Number	:	937-286-7603
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2021
Last Update Date	:	01/12/2021

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Directions to “ MICHAEL IOANES ” Practice Location

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