MEDICARE: NURSE MEDICAL HEALTHCARE SERVICES 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	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1033300462
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NURSE MEDICAL HEALTHCARE SERVICES LLC

Provider Business Mailing Address
First Line	:	4770 INDIANOLA AVE
Second Line	:	SUITE 270
City	:	COLUMBUS
State	:	OH
Zip	:	43214-1862
Country	:	US
Telephone Number	:	614-781-0244
Fax Number	:	614-781-0208

Provider Business Practice Location Address
First Line	:	4770 INDIANOLA AVE
Second Line	:	SUITE 270
City	:	COLUMBUS
State	:	OH
Zip	:	43214-1862
Country	:	US
Telephone Number	:	614-781-0244
Fax Number	:	614-781-0208

Authorized Official
Title or Position	:	PRESIDENT CEO
Name	:	MR. JOHNNIE LEE BERRY
Credential	:
Telephone Number	:	614-781-0244

Provider Enumeration Date	:	08/09/2007
Last Update Date	:	09/01/2007

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