MEDICARE: JIMMIE MYREE JR.

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	376J00000X	Homemaker

General Provider Information

NPI Number	:	1295424067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIMMIE MYREE JR.

Provider Business Mailing Address
First Line	:	3529 RADCLIFF RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44121-1547
Country	:	US
Telephone Number	:	216-356-7333
Fax Number	:

Provider Business Practice Location Address
First Line	:	3529 RADCLIFF RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44121-1547
Country	:	US
Telephone Number	:	216-356-7333
Fax Number	:

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

Provider Enumeration Date	:	05/05/2023
Last Update Date	:	05/05/2023

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Directions to “ JIMMIE MYREE JR. ” Practice Location

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