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NPI Code Detail

MEDICARE: TAN EXECUTIVES

MEDICARE: TAN EXECUTIVES
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
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1154009835
Entity Type Code : Organization
Provider Name (Legal Business Name) : TAN EXECUTIVES
Provider Business Mailing Address
First Line : PO BOX 140995
Second Line :
City : TOLEDO
State : OH
Zip : 43614-0995
Country : US
Telephone Number : 567-377-0531
Fax Number :
Provider Business Practice Location Address
First Line : 2560 KEY ST APT 4A
Second Line :
City : TOLEDO
State : OH
Zip : 43614-4818
Country : US
Telephone Number : 567-377-0531
Fax Number :
Authorized Official
Title or Position : OWNER
Name : TAINE NEDD
Credential :
Telephone Number : 567-377-0531
Provider Enumeration Date : 07/11/2023
Last Update Date : 07/11/2023

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Directions to “TAN EXECUTIVES ” Practice Location

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