MEDICARE: KIMHAM COACHES YOU 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		OH

General Provider Information

NPI Number	:	1356528319
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIMHAM COACHES YOU LLC

Provider Business Mailing Address
First Line	:	223 CHURCHILL HUBBARD RD
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44505-1324
Country	:	US
Telephone Number	:	330-720-0441
Fax Number	:	330-759-7318

Provider Business Practice Location Address
First Line	:	223 CHURCHILL HUBBARD RD
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44505-1324
Country	:	US
Telephone Number	:	330-720-0441
Fax Number	:	330-759-7318

Authorized Official
Title or Position	:	CEO
Name	:	KIMBERLY ANNE HAMILTON
Credential	:	REGISTERED NURSE
Telephone Number	:	330-720-3456

Provider Enumeration Date	:	01/22/2008
Last Update Date	:	01/22/2008

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