MEDICARE: CLARANNE BOHN

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	:	1386457224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLARANNE BOHN

Provider Business Mailing Address
First Line	:	104 CLEVELAND ST
Second Line	:
City	:	BLOOMDALE
State	:	OH
Zip	:	44817-9752
Country	:	US
Telephone Number	:	419-265-5670
Fax Number	:

Provider Business Practice Location Address
First Line	:	104 CLEVELAND ST
Second Line	:
City	:	BLOOMDALE
State	:	OH
Zip	:	44817-9752
Country	:	US
Telephone Number	:	419-265-5670
Fax Number	:

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

Provider Enumeration Date	:	01/27/2025
Last Update Date	:	01/27/2025

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