MEDICARE: TAUNYA ROCK

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
1	246RP1900X	Phlebotomy Technician

General Provider Information

NPI Number	:	1194153460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAUNYA ROCK

Provider Business Mailing Address
First Line	:	3593 PENNINGTON RD
Second Line	:
City	:	SHAKER HTS
State	:	OH
Zip	:	44120-5013
Country	:	US
Telephone Number	:	216-233-8252
Fax Number	:	855-270-4695

Provider Business Practice Location Address
First Line	:	3593 PENNINGTON RD
Second Line	:
City	:	SHAKER HTS
State	:	OH
Zip	:	44120-5013
Country	:	US
Telephone Number	:	216-333-6025
Fax Number	:	185-527-0469

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2013
Last Update Date	:	10/24/2013

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Directions to “ TAUNYA ROCK ” Practice Location

Language	Start Address	Practice Location

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