Healthcare Provider Details

I. General information

NPI: 1104205251
Provider Name (Legal Business Name): HERE TO THERE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2015
Last Update Date: 06/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6314 EDWOOD AVE # B
CINCINNATI OH
45224-2104
US

IV. Provider business mailing address

6314 EDWOOD AVE # B
CINCINNATI OH
45224-2104
US

V. Phone/Fax

Practice location:
  • Phone: 513-371-8613
  • Fax:
Mailing address:
  • Phone: 513-371-8613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MISS JENNDORIAN ELIZABETH SMITH
Title or Position: VICE PRESIDENT
Credential: LPN
Phone: 513-371-8613