MEDICARE: SANDRA TOLLIVER

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	171M00000X	Case Manager/Care Coordinator		OH

Other Identifiers

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

General Provider Information

NPI Number	:	1477975209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA TOLLIVER

Provider Business Mailing Address
First Line	:	4721 READING RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-6107
Country	:	US
Telephone Number	:	513-653-0823
Fax Number	:

Provider Business Practice Location Address
First Line	:	2867 ORLAND AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-8020
Country	:	US
Telephone Number	:	513-415-9606
Fax Number	:

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

Provider Enumeration Date	:	01/14/2014
Last Update Date	:	06/03/2025

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Directions to “ SANDRA TOLLIVER ” Practice Location

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