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NPI Code Detail

MEDICARE: HOUSE OF SHEARS SUITES LLC

MEDICARE: HOUSE OF SHEARS SUITES 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
11744P3200XProsthetics Case Management
2332B00000XDurable Medical Equipment & Medical Supplies
3332BC3200XCustomized Equipment (DME)

General Provider Information

NPI Number : 1851980007
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOUSE OF SHEARS SUITES LLC
Provider Business Mailing Address
First Line : 5914 GLENWAY AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45238-2009
Country : US
Telephone Number : 513-462-9864
Fax Number :
Provider Business Practice Location Address
First Line : 5914 GLENWAY AVE
Second Line :
City : CINCINNATI
State : OH
Zip : 45238-2009
Country : US
Telephone Number : 513-462-9864
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MALLORY MARIE WASTSON
Credential :
Telephone Number : 513-478-4169
Provider Enumeration Date : 01/12/2021
Last Update Date : 01/15/2021

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Directions to “HOUSE OF SHEARS SUITES LLC ” Practice Location

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