MEDICARE: WALTON HOME AND HEALTH CARE 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	253Z00000X	In Home Supportive Care Agency	201324701642	OH

General Provider Information

NPI Number	:	1083032049
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALTON HOME AND HEALTH CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	591 BANNINGWAY DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-3429
Country	:	US
Telephone Number	:	614-284-2390
Fax Number	:

Provider Business Practice Location Address
First Line	:	591 BANNINGWAY DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-3429
Country	:	US
Telephone Number	:	614-284-2390
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BETTY J WALTON
Credential	:
Telephone Number	:	614-284-2390

Provider Enumeration Date	:	04/06/2014
Last Update Date	:	04/06/2014

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