MEDICARE: NORTH COLLEGE HILL COMMUNITY SENIORS INC.

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	332U00000X	Home Delivered Meals

General Provider Information

NPI Number	:	1548678642
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH COLLEGE HILL COMMUNITY SENIORS INC.

Provider Business Mailing Address
First Line	:	1586 GOODMAN AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45224-1005
Country	:	US
Telephone Number	:	513-521-3462
Fax Number	:	513-521-2365

Provider Business Practice Location Address
First Line	:	1586 GOODMAN AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45224-1005
Country	:	US
Telephone Number	:	513-521-3462
Fax Number	:	513-521-2365

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. ROBERT DAVID GUNN
Credential	:
Telephone Number	:	513-521-3462

Provider Enumeration Date	:	08/01/2014
Last Update Date	:	08/01/2014

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