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NPI Code Detail

MEDICARE: LORA C LOGAN

MEDICARE:   LORA C LOGAN
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
1253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1144817016
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORA C LOGAN
Provider Business Mailing Address
First Line : 4051 VINESHIRE DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43227-3692
Country : US
Telephone Number : 614-743-8165
Fax Number :
Provider Business Practice Location Address
First Line : 6655 SHARON WOODS BLVD
Second Line :
City : COLUMBUS
State : OH
Zip : 43229-7019
Country : US
Telephone Number : 614-743-8165
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2020
Last Update Date : 12/28/2020

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Directions to “ LORA C LOGAN ” Practice Location

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