MEDICARE: CAROL MARSH

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	347C00000X	Private Vehicle
2	376J00000X	Homemaker
3	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1326654203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL MARSH

Provider Business Mailing Address
First Line	:	1697 MORRIS ST
Second Line	:
City	:	MINERAL RIDGE
State	:	OH
Zip	:	44440-9797
Country	:	US
Telephone Number	:	330-984-6464
Fax Number	:

Provider Business Practice Location Address
First Line	:	1697 MORRIS ST
Second Line	:
City	:	MINERAL RIDGE
State	:	OH
Zip	:	44440-9797
Country	:	US
Telephone Number	:	330-984-6464
Fax Number	:

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

Provider Enumeration Date	:	09/16/2020
Last Update Date	:	09/16/2020

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Directions to “ CAROL MARSH ” Practice Location

Language	Start Address	Practice Location

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