MEDICARE: GERRAILL TYRONE MILLER

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1861098683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERRAILL TYRONE MILLER

Provider Business Mailing Address
First Line	:	2745 BRISTOL HILL CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45239-7705
Country	:	US
Telephone Number	:	513-557-1405
Fax Number	:

Provider Business Practice Location Address
First Line	:	2745 BRISTOL HILL CT
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45239-7705
Country	:	US
Telephone Number	:	513-557-1405
Fax Number	:

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

Provider Enumeration Date	:	12/07/2020
Last Update Date	:	12/07/2020

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Directions to “ GERRAILL TYRONE MILLER ” Practice Location

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