MEDICARE: ASIA SANDERS STNA, PCA

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	251E00000X	Home Health Agency
2	332U00000X	Home Delivered Meals
3	347C00000X	Private Vehicle
4	374U00000X	Home Health Aide
5	376J00000X	Homemaker
6	376K00000X	Nurse's Aide	401984290717	OH

General Provider Information

NPI Number	:	1053017889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASIA SANDERS STNA, PCA

Provider Business Mailing Address
First Line	:	11029 QUAILRIDGE CT APT 2
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45240-2787
Country	:	US
Telephone Number	:	513-903-5775
Fax Number	:

Provider Business Practice Location Address
First Line	:	11029 QUAILRIDGE CT APT 2
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45240-2787
Country	:	US
Telephone Number	:	513-903-5775
Fax Number	:

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

Provider Enumeration Date	:	02/02/2023
Last Update Date	:	02/02/2023

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