MEDICARE: MISSHAZEL HOGAN

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

General Provider Information

NPI Number	:	1093384158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISSHAZEL HOGAN

Provider Business Mailing Address
First Line	:	1639 CATALPA RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44112-1006
Country	:	US
Telephone Number	:	216-624-8976
Fax Number	:

Provider Business Practice Location Address
First Line	:	1639 CATALPA RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44112-1006
Country	:	US
Telephone Number	:	216-624-8976
Fax Number	:

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

Provider Enumeration Date	:	06/23/2021
Last Update Date	:	06/23/2021

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Directions to “ MISSHAZEL HOGAN ” Practice Location

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