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NPI Code Detail

MEDICARE: MELINDA BETH JACOB COTA

MEDICARE: MELINDA BETH JACOB COTA
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
1314000000XSkilled Nursing FacilityOTA02908OH

General Provider Information

NPI Number : 1184748659
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELINDA BETH JACOB COTA
Provider Business Mailing Address
First Line : 5864 BEECHAM DRIVE
Second Line :
City : HUBER HEIGHTS
State : OH
Zip : 45424
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1390 KING TREE DR
Second Line :
City : DAYTON
State : OH
Zip : 45405-1401
Country : US
Telephone Number : 937-278-0723
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 07/08/2007

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Directions to “ MELINDA BETH JACOB COTA” Practice Location

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