MEDICARE: DEANNA IONE WARE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	347E00000X	Transportation Broker
2	372600000X	Adult Companion
3	385H00000X	Respite Care
4	385HR2065X	Child Physical Disabilities Respite Care
5	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1073373973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEANNA IONE WARE

Provider Business Mailing Address
First Line	:	650 S LAKE ST
Second Line	:
City	:	GARY
State	:	IN
Zip	:	46403-2927
Country	:	US
Telephone Number	:	219-314-8913
Fax Number	:

Provider Business Practice Location Address
First Line	:	1119 DALLAS ST
Second Line	:
City	:	GARY
State	:	IN
Zip	:	46406-2366
Country	:	US
Telephone Number	:	219-314-8913
Fax Number	:

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

Provider Enumeration Date	:	03/20/2024
Last Update Date	:	03/20/2024

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Directions to “ DEANNA IONE WARE ” Practice Location

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