MEDICARE: HERE TO THERE

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	347C00000X	Private Vehicle

General Provider Information

NPI Number	:	1104205251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HERE TO THERE

Provider Business Mailing Address
First Line	:	6314 EDWOOD AVE # B
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45224-2104
Country	:	US
Telephone Number	:	513-371-8613
Fax Number	:

Provider Business Practice Location Address
First Line	:	6314 EDWOOD AVE # B
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45224-2104
Country	:	US
Telephone Number	:	513-371-8613
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MISS JENNDORIAN ELIZABETH SMITH
Credential	:	LPN
Telephone Number	:	513-371-8613

Provider Enumeration Date	:	05/22/2015
Last Update Date	:	06/03/2016

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Directions to “HERE TO THERE ” Practice Location

Language	Start Address	Practice Location

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