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NPI Code Detail

MEDICARE: MARIO CARNELL SCOTT DSP

MEDICARE:   MARIO CARNELL SCOTT  DSP
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 : 1164244075
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIO CARNELL SCOTT DSP
Provider Business Mailing Address
First Line : 838 WADE WALK APT F
Second Line :
City : CINCINNATI
State : OH
Zip : 45214-3415
Country : US
Telephone Number : 513-501-8763
Fax Number :
Provider Business Practice Location Address
First Line : 838 WADE WALK APT F
Second Line :
City : CINCINNATI
State : OH
Zip : 45214-3415
Country : US
Telephone Number : 513-501-8763
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2024
Last Update Date : 10/30/2024

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Directions to “ MARIO CARNELL SCOTT DSP” Practice Location

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