MEDICARE: MRS. RAHA AHMED OSMAN

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	3747P1801X	Personal Care Attendant
2	172A00000X	Driver	VA654592	OH
3	374U00000X	Home Health Aide
4	376J00000X	Homemaker
5	342000000X	Transportation Network Company	VA654592	OH

General Provider Information

NPI Number	:	1528849825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RAHA AHMED OSMAN

Provider Business Mailing Address
First Line	:	3261 AGAPE DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-3793
Country	:	US
Telephone Number	:	304-437-9387
Fax Number	:

Provider Business Practice Location Address
First Line	:	3261 AGAPE DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-3793
Country	:	US
Telephone Number	:	304-437-9387
Fax Number	:

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

Provider Enumeration Date	:	10/12/2023
Last Update Date	:	10/12/2023

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