Healthcare Provider Details

I. General information

NPI: 1609628338
Provider Name (Legal Business Name): GERI-FIRST, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2024
Last Update Date: 06/11/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

585 N STATE ROUTE 741
LEBANON OH
45036-3313
US

IV. Provider business mailing address

8342 ASHMONT WAY
MASON OH
45040-5006
US

V. Phone/Fax

Practice location:
  • Phone: 513-932-2020
  • Fax:
Mailing address:
  • Phone: 937-309-3017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JILL M LATHAM
Title or Position: BILLING/CREDENTIALING
Credential:
Phone: 937-309-3017