MEDICARE: TONIC

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	251J00000X	Nursing Care Agency	PN151581-M-IV	OH

General Provider Information

NPI Number	:	1437496007
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TONIC

Provider Business Mailing Address
First Line	:	4019 BURNELL CIR W
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-1881
Country	:	US
Telephone Number	:	614-556-6903
Fax Number	:

Provider Business Practice Location Address
First Line	:	4019 BURNELL CIR W
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-1881
Country	:	US
Telephone Number	:	614-556-6903
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. NICODEMUS TOSAH
Credential	:	LPN
Telephone Number	:	614-556-6903

Provider Enumeration Date	:	01/15/2013
Last Update Date	:	01/15/2013

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Directions to “TONIC ” Practice Location

Language	Start Address	Practice Location

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