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NPI Code Detail

MEDICARE: JANNAH HOME HEALTHCARE

MEDICARE: JANNAH HOME HEALTHCARE
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
1305R00000XPreferred Provider Organization

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164763926
Entity Type Code : Organization
Provider Name (Legal Business Name) : JANNAH HOME HEALTHCARE
Provider Business Mailing Address
First Line : 2133 W NORTH AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53205-1133
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2133 W NORTH AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53205-1133
Country : US
Telephone Number : 414-342-2500
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : MS. LATOYA DIXON
Credential :
Telephone Number : 414-342-2500
Provider Enumeration Date : 03/04/2013
Last Update Date : 03/04/2013

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Directions to “JANNAH HOME HEALTHCARE ” Practice Location

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