MEDICARE: ASHARIS HEALTHCARE, LLC

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	163WH0200X	Home Health Registered Nurse	RN286834	OH

General Provider Information

NPI Number	:	1831389790
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASHARIS HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	6614 SCHAEFER AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44103-1956
Country	:	US
Telephone Number	:	216-432-0899
Fax Number	:	216-431-4736

Provider Business Practice Location Address
First Line	:	6614 SCHAEFER AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44103-1956
Country	:	US
Telephone Number	:	216-432-0899
Fax Number	:	216-431-4736

Authorized Official
Title or Position	:	CEO
Name	:	MRS. LOJUANAH DENEA DUNN - FARNEY
Credential	:	RN
Telephone Number	:	216-432-0899

Provider Enumeration Date	:	07/27/2007
Last Update Date	:	07/27/2007

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