=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497938781
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | YONA FORD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/11/2007
-----------------------------------------------------
Last Update Date | 08/21/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2145 SUMAC LOOP N
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43229-3937
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-307-9293
-----------------------------------------------------
Fax | 614-882-6588
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2145 SUMAC LOOP N
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43229-3937
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-307-9293
-----------------------------------------------------
Fax | 614-882-6588
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LICENSED PRACTICAL NURSE
-----------------------------------------------------
Name | MRS. YONA YVETTE FORD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 614-307-9293
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 1743501
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------