Healthcare Provider Details

I. General information

NPI: 1861335705
Provider Name (Legal Business Name): JOSEPH A GEORGE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6315 SHADOW CREEK DR
MEDINA OH
44256-7804
US

IV. Provider business mailing address

6315 SHADOW CREEK DR
MEDINA OH
44256-7804
US

V. Phone/Fax

Practice location:
  • Phone: 216-804-2469
  • Fax:
Mailing address:
  • Phone: 216-804-2469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: