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NPI Code Detail

MEDICARE: MR. JOSEPH CHARLES BURST

MEDICARE: MR. JOSEPH CHARLES BURST
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
13747P1801XPersonal Care Attendant3747P1801XOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10000272862OTHEROHOHIO SHARED SERVICES
23124885OTHEROHDODD

General Provider Information

NPI Number : 1104420454
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOSEPH CHARLES BURST
Provider Business Mailing Address
First Line : 7343 COMMONWEALTH DR
Second Line :
City : CINCINNATI
State : OH
Zip : 45224-1413
Country : US
Telephone Number : 513-390-2773
Fax Number :
Provider Business Practice Location Address
First Line : 7343 COMMONWEALTH DR
Second Line :
City : CINCINNATI
State : OH
Zip : 45224-1413
Country : US
Telephone Number : 513-240-6262
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2020
Last Update Date : 11/27/2020

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Directions to “ MR. JOSEPH CHARLES BURST ” Practice Location

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