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General NPI Number Information
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NPI Number | 1821665423
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Entity Type | Organization
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Legal Business Name | MOBILE NP LLC
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Dates
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Enumeration Date | 06/10/2021
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Last Update Date | 01/31/2022
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Provider Practice Location Address
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Address Line | 9996 BAUGHMAN RD
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City | HARRISON
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State | OH
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Zip | 45030-1714
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Country | US
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Telephone | 513-560-2904
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Fax | 855-483-9360
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Provider Business Mailing Address
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Address Line | 9996 BAUGHMAN RD
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City | HARRISON
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State | OH
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Zip | 45030-1714
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Country | US
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Telephone | 513-560-2904
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHANNON CARUSO
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Credential | NP
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Telephone | 513-560-2904
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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