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NPI Code Detail

MEDICARE: HOLLY ANGUS

MEDICARE: HOLLY ANGUS
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
1251B00000XCase Management Agency
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1154803617
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLY ANGUS
Provider Business Mailing Address
First Line : 5925 CLEVELAND AVE STE B
Second Line :
City : COLUMBUS
State : OH
Zip : 43231-2209
Country : US
Telephone Number : 614-776-4646
Fax Number :
Provider Business Practice Location Address
First Line : 5925 CLEVELAND AVE STE B
Second Line :
City : COLUMBUS
State : OH
Zip : 43231-2209
Country : US
Telephone Number : 614-776-4646
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2018
Last Update Date : 09/21/2018

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Directions to “ HOLLY ANGUS ” Practice Location

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