MEDICARE: R MICHAEL KACUR

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	RR232372	OH
2	374U00000X	Home Health Aide	RR232372	OH

General Provider Information

NPI Number	:	1467226951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	R MICHAEL KACUR

Provider Business Mailing Address
First Line	:	2217 GARDEN DR
Second Line	:
City	:	AVON
State	:	OH
Zip	:	44011-2601
Country	:	US
Telephone Number	:	440-731-6301
Fax Number	:

Provider Business Practice Location Address
First Line	:	2217 GARDEN DR
Second Line	:
City	:	AVON
State	:	OH
Zip	:	44011-2601
Country	:	US
Telephone Number	:	440-731-6301
Fax Number	:

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

Provider Enumeration Date	:	11/14/2023
Last Update Date	:	11/14/2023

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Directions to “ R MICHAEL KACUR ” Practice Location

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