MEDICARE: WAYNE SCHMITZ

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1538762026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WAYNE SCHMITZ

Provider Business Mailing Address
First Line	:	9722 MORROW WOODVILLE RD
Second Line	:
City	:	PLEASANT PLAIN
State	:	OH
Zip	:	45162-9312
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9722 MORROW WOODVILLE RD
Second Line	:
City	:	PLEASANT PLAIN
State	:	OH
Zip	:	45162-9312
Country	:	US
Telephone Number	:	937-725-1395
Fax Number	:

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

Provider Enumeration Date	:	11/18/2020
Last Update Date	:	11/18/2020

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Directions to “ WAYNE SCHMITZ ” Practice Location

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