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NPI Code Detail

MEDICARE: ROLANDO JERMAINE RANSOM BA

MEDICARE: ROLANDO JERMAINE RANSOM BA
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
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1669298493
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROLANDO JERMAINE RANSOM BA
Provider Business Mailing Address
First Line : 2359 KNOLLWOOD AVE
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44514-1525
Country : US
Telephone Number : 216-260-1405
Fax Number : 330-632-8823
Provider Business Practice Location Address
First Line : 850 HOWLAND WILSON RD NE
Second Line :
City : WARREN
State : OH
Zip : 44484-2116
Country : US
Telephone Number : 216-260-1405
Fax Number : 330-632-8823
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2024
Last Update Date : 11/26/2024

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Directions to “ ROLANDO JERMAINE RANSOM BA” Practice Location

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