MEDICARE: LUCY ANN LONGMIRE

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	253Z00000X	In Home Supportive Care Agency
2	372600000X	Adult Companion		OH

General Provider Information

NPI Number	:	1376254938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUCY ANN LONGMIRE

Provider Business Mailing Address
First Line	:	5740 DAVEY AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45224-2967
Country	:	US
Telephone Number	:	513-290-9050
Fax Number	:

Provider Business Practice Location Address
First Line	:	5740 DAVEY AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45224-2967
Country	:	US
Telephone Number	:	513-290-9050
Fax Number	:

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

Provider Enumeration Date	:	12/05/2022
Last Update Date	:	12/05/2022

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Directions to “ LUCY ANN LONGMIRE ” Practice Location

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