MEDICARE: EUGENIA DIONNE BLACK

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		OH
2	3747P1801X	Personal Care Attendant		OH

General Provider Information

NPI Number	:	1881535177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EUGENIA DIONNE BLACK

Provider Business Mailing Address
First Line	:	187 OAK ST
Second Line	:
City	:	FAIRBORN
State	:	OH
Zip	:	45324-3341
Country	:	US
Telephone Number	:	720-241-1657
Fax Number	:

Provider Business Practice Location Address
First Line	:	187 OAK ST
Second Line	:
City	:	FAIRBORN
State	:	OH
Zip	:	45324-3341
Country	:	US
Telephone Number	:	720-241-1657
Fax Number	:

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

Provider Enumeration Date	:	04/02/2026
Last Update Date	:	04/02/2026

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Directions to “ EUGENIA DIONNE BLACK ” Practice Location

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