MEDICARE: DONNITA THREATT

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	343900000X	Non-emergency Medical Transport (VAN)
2	347C00000X	Private Vehicle
3	3747P1801X	Personal Care Attendant
4	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1275270985
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNITA THREATT

Provider Business Mailing Address
First Line	:	1358 SEWARD AVE
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44320-3338
Country	:	US
Telephone Number	:	234-200-9681
Fax Number	:

Provider Business Practice Location Address
First Line	:	1358 SEWARD AVE
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44320-3338
Country	:	US
Telephone Number	:	234-200-9681
Fax Number	:

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

Provider Enumeration Date	:	05/14/2022
Last Update Date	:	05/14/2022

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Directions to “ DONNITA THREATT ” Practice Location

Language	Start Address	Practice Location

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