MEDICARE: ALG CONSULTING LLC

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	363LA2200X	Adult Health Nurse Practitioner	03609	OH

General Provider Information

NPI Number	:	1023561453
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALG CONSULTING LLC

Provider Business Mailing Address
First Line	:	9345 SUSSEX DR
Second Line	:
City	:	OLMSTED FALLS
State	:	OH
Zip	:	44138-2613
Country	:	US
Telephone Number	:	440-503-4209
Fax Number	:	440-237-3626

Provider Business Practice Location Address
First Line	:	9345 SUSSEX DR
Second Line	:
City	:	OLMSTED FALLS
State	:	OH
Zip	:	44138-2613
Country	:	US
Telephone Number	:	440-503-4209
Fax Number	:	440-237-3626

Authorized Official
Title or Position	:	PRESIDENT OWNER
Name	:	MRS. ANITA GROESCHKE
Credential	:	CRNP
Telephone Number	:	440-503-4209

Provider Enumeration Date	:	08/02/2016
Last Update Date	:	08/02/2016

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