Healthcare Provider Details

I. General information

NPI: 1427694769
Provider Name (Legal Business Name): ALEXUS D GAINES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2019
Last Update Date: 11/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4603 WILLIAMSBURG RD N
CINCINNATI OH
45215-5143
US

IV. Provider business mailing address

4603 WILLIAMSBURG RD N
CINCINNATI OH
45215-5143
US

V. Phone/Fax

Practice location:
  • Phone: 513-551-6755
  • Fax:
Mailing address:
  • Phone: 513-551-6755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: