MEDICARE: MR. NATHAN HOWARD GAILEY

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1295948891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NATHAN HOWARD GAILEY

Provider Business Mailing Address
First Line	:	2596 ELLEN DR.
Second Line	:
City	:	LEXINGTON
State	:	OH
Zip	:	44904
Country	:	US
Telephone Number	:	419-884-3065
Fax Number	:

Provider Business Practice Location Address
First Line	:	2596 ELLEN AVE
Second Line	:
City	:	LEXINGTON
State	:	OH
Zip	:	44904-1413
Country	:	US
Telephone Number	:	419-884-3065
Fax Number	:

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

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	07/08/2007

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