MEDICARE: EMPLOYEE NETWORK INC

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	251S00000X	Community/Behavioral Health Agency	C.1300172	OH

General Provider Information

NPI Number	:	1538530308
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPLOYEE NETWORK INC

Provider Business Mailing Address
First Line	:	1040 VESTAL PKWY E
Second Line	:
City	:	VESTAL
State	:	NY
Zip	:	13850-1748
Country	:	US
Telephone Number	:	800-364-4748
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 VERNON PL
Second Line	:	SUITE 2100
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2436
Country	:	US
Telephone Number	:	800-364-4748
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. CHRIS DIXON
Credential	:
Telephone Number	:	800-364-4748

Provider Enumeration Date	:	10/19/2015
Last Update Date	:	10/19/2015

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Directions to “EMPLOYEE NETWORK INC ” Practice Location

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