=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770241986
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PARAMOUNT CHOICE FOR LIVING & TRANSPORTATION SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/05/2021
-----------------------------------------------------
Last Update Date | 12/05/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1674 CORDELL AVE
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43219-1049
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-398-0350
-----------------------------------------------------
Fax | 614-675-8626
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1674 CORDELL AVE
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43219-1049
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-398-0350
-----------------------------------------------------
Fax | 614-675-8626
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF OPERATIONS
-----------------------------------------------------
Name | TASHIANNA AMOINIQUE LATROBE KWAKYE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 614-398-0350
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374U00000X
-----------------------------------------------------
Taxonomy Name | Home Health Aide
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------