MEDICARE: IP NURSES AIDE

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	305R00000X	Preferred Provider Organization

General Provider Information

NPI Number	:	1124142120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IP NURSES AIDE

Provider Business Mailing Address
First Line	:	PO BOX 130
Second Line	:
City	:	BEALLSVILLE
State	:	OH
Zip	:	43716-0130
Country	:	US
Telephone Number	:	740-213-0567
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 CLARK ST
Second Line	:
City	:	POWHATAN POINT
State	:	OH
Zip	:	43942-1261
Country	:	US
Telephone Number	:	740-795-5946
Fax Number	:

Authorized Official
Title or Position	:	NONE AGENCY NURSES AIDE
Name	:	MR. GREGORY JASON SMITH
Credential	:
Telephone Number	:	740-213-0567

Provider Enumeration Date	:	03/17/2007
Last Update Date	:	08/22/2020

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Directions to “IP NURSES AIDE ” Practice Location

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