MEDICARE: MEARA SPAULDING IP

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	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1235516345
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEARA SPAULDING IP

Provider Business Mailing Address
First Line	:	6015 DRYDEN AVE APT 4
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45213-1750
Country	:	US
Telephone Number	:	513-551-8359
Fax Number	:

Provider Business Practice Location Address
First Line	:	6015 DRYDEN AVE
Second Line	:	APT. 4
City	:	CINCINNATI
State	:	OH
Zip	:	45213-1750
Country	:	US
Telephone Number	:	513-551-8359
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MEARA EDWARDS SPAULDING
Credential	:	LPN
Telephone Number	:	513-551-8359

Provider Enumeration Date	:	04/28/2015
Last Update Date	:	04/28/2015

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