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General NPI Number Information
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NPI Number | 1619356243
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Entity Type | Organization
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Legal Business Name | EDNA TWEEDY
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Dates
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Enumeration Date | 05/28/2015
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Last Update Date | 05/28/2015
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Provider Practice Location Address
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Address Line | 3637 WABASH AVE
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City | CINCINNATI
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State | OH
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Zip | 45207-1223
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Country | US
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Telephone | 513-546-8866
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Fax |
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Provider Business Mailing Address
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Address Line | 3637 WABASH AVE
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City | CINCINNATI
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State | OH
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Zip | 45207-1223
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Country | US
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Telephone | 513-546-8866
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Fax |
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Authorized Official
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Title or Position | STNA
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Name | EDNA VALEANE TWEEDY
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Credential |
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Telephone | 513-546-8866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 310004560991
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License Number State | OH
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