MEDICARE: ABEDALE SAMUEL

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1689516262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABEDALE SAMUEL

Provider Business Mailing Address
First Line	:	7838 PINEHILL RD
Second Line	:
City	:	LEWIS CENTER
State	:	OH
Zip	:	43035-6040
Country	:	US
Telephone Number	:	614-940-7081
Fax Number	:

Provider Business Practice Location Address
First Line	:	7838 PINEHILL RD
Second Line	:
City	:	LEWIS CENTER
State	:	OH
Zip	:	43035-6040
Country	:	US
Telephone Number	:	614-940-7081
Fax Number	:

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

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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