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NPI Code Detail

MEDICARE: CLEOYVONTA MITCHELLE LONGMIRE

MEDICARE: CLEOYVONTA MITCHELLE 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
1343900000XNon-emergency Medical Transport (VAN)RR536538OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477803823
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLEOYVONTA MITCHELLE LONGMIRE
Provider Business Mailing Address
First Line : 3030 W FORK RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45211-1944
Country : US
Telephone Number : 513-562-0102
Fax Number :
Provider Business Practice Location Address
First Line : 3030 W FORK RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45211-1944
Country : US
Telephone Number : 800-562-0102
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2012
Last Update Date : 04/21/2015

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Directions to “ CLEOYVONTA MITCHELLE LONGMIRE ” Practice Location

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