Healthcare Provider Details

I. General information

NPI: 1689320046
Provider Name (Legal Business Name): MONICA N ORANGE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2022
Last Update Date: 02/24/2022
Certification Date: 02/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

398 W BAGLEY RD STE 20J
BEREA OH
44017-1312
US

IV. Provider business mailing address

398 W BAGLEY RD STE 20J
BEREA OH
44017-1312
US

V. Phone/Fax

Practice location:
  • Phone: 440-230-1030
  • Fax:
Mailing address:
  • Phone: 440-230-1030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number0139965
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: