MEDICARE: TASHAY JOHNNY & ADDIES WAY 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1336936004
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TASHAY JOHNNY & ADDIES WAY LLC

Provider Business Mailing Address
First Line	:	8980 TRIPOLI DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45251-3063
Country	:	US
Telephone Number	:	513-746-8277
Fax Number	:

Provider Business Practice Location Address
First Line	:	8980 TRIPOLI DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45251-3063
Country	:	US
Telephone Number	:	513-746-8277
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CORLISS WEST
Credential	:
Telephone Number	:	513-746-8277

Provider Enumeration Date	:	04/24/2025
Last Update Date	:	04/24/2025

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