MEDICARE: MRS. ERICA PORCH

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	:	1740059518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ERICA PORCH

Provider Business Mailing Address
First Line	:	116 ROBINWOOD DR
Second Line	:
City	:	NEW MIDDLETOWN
State	:	OH
Zip	:	44442-9721
Country	:	US
Telephone Number	:	330-881-0781
Fax Number	:

Provider Business Practice Location Address
First Line	:	116 ROBINWOOD DR
Second Line	:
City	:	NEW MIDDLETOWN
State	:	OH
Zip	:	44442-9721
Country	:	US
Telephone Number	:	330-881-0781
Fax Number	:

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

Provider Enumeration Date	:	12/21/2023
Last Update Date	:	12/21/2023

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Directions to “ MRS. ERICA PORCH ” Practice Location

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