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NPI Code Detail

MEDICARE: BROOKE

MEDICARE: BROOKE
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
1251J00000XNursing Care Agency133427OH

General Provider Information

NPI Number : 1558797183
Entity Type Code : Organization
Provider Name (Legal Business Name) : BROOKE
Provider Business Mailing Address
First Line : 1333 HOLLYWOOD AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45224-1532
Country : US
Telephone Number : 513-923-7897
Fax Number :
Provider Business Practice Location Address
First Line : 1333 HOLLYWOOD AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45224-1532
Country : US
Telephone Number : 513-923-7897
Fax Number :
Authorized Official
Title or Position : LPN
Name : BROOKE GOODWIN
Credential :
Telephone Number : 513923789325
Provider Enumeration Date : 09/14/2013
Last Update Date : 09/14/2013

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Directions to “BROOKE ” Practice Location

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