MEDICARE: RALPH G PERRY

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	163WH0200X	Home Health Registered Nurse	1398813	OH
2	164W00000X	Licensed Practical Nurse	1398813	OH
3	374U00000X	Home Health Aide	1398813	OH

General Provider Information

NPI Number	:	1457677544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RALPH G PERRY

Provider Business Mailing Address
First Line	:	5969 E LIVINGSTON AVE
Second Line	:	SUITE 110
City	:	COLUMBUS
State	:	OH
Zip	:	43232-2907
Country	:	US
Telephone Number	:	614-863-6950
Fax Number	:	614-863-6957

Provider Business Practice Location Address
First Line	:	5969 E LIVINGSTON AVE
Second Line	:	SUITE 110
City	:	COLUMBUS
State	:	OH
Zip	:	43232-2907
Country	:	US
Telephone Number	:	614-863-6950
Fax Number	:	614-863-6957

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

Provider Enumeration Date	:	04/14/2010
Last Update Date	:	04/14/2010

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Directions to “ RALPH G PERRY ” Practice Location

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