MEDICARE: JOHN ANILE

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	310400000X	Assisted Living Facility	PTA003252	GA

General Provider Information

NPI Number	:	1376914143
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN ANILE

Provider Business Mailing Address
First Line	:	6300 MILGEN RD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31907-5889
Country	:	US
Telephone Number	:	334-467-0032
Fax Number	:

Provider Business Practice Location Address
First Line	:	6300 MILGEN RD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31907-5889
Country	:	US
Telephone Number	:	334-467-0032
Fax Number	:

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

Provider Enumeration Date	:	10/19/2015
Last Update Date	:	10/19/2015

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Directions to “ JOHN ANILE ” Practice Location

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