MEDICARE: MS. MERION ALICE BROWN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1013042563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MERION ALICE BROWN

Provider Business Mailing Address
First Line	:	170 CLARENDON AVENUE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43223
Country	:	US
Telephone Number	:	614-309-2015
Fax Number	:

Provider Business Practice Location Address
First Line	:	984 MILLER AVENUE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43206
Country	:	US
Telephone Number	:	614-253-7568
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2007
Last Update Date	:	07/08/2007

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