MEDICARE: MR. FRED A THOMAS SR. MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	251E00000X	Home Health Agency
2	253Z00000X	In Home Supportive Care Agency
3	347C00000X	Private Vehicle
4	374U00000X	Home Health Aide
5	320700000X	Physical Disabilities Residential Treatment Facility	OH

General Provider Information

NPI Number	:	1205633211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FRED A THOMAS SR. MA

Provider Business Mailing Address
First Line	:	1991 HEATHCLIFF DR APT 2B
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43209-3429
Country	:	US
Telephone Number	:	614-397-0728
Fax Number	:

Provider Business Practice Location Address
First Line	:	1991 HEATHCLIFF DR APT 2B
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43209-3429
Country	:	US
Telephone Number	:	614-397-0728
Fax Number	:

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

Provider Enumeration Date	:	02/26/2025
Last Update Date	:	07/16/2025

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