MEDICARE: RACHEL BETH WAY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	172A00000X	Driver
2	251X00000X	Supports Brokerage Agency
3	3747P1801X	Personal Care Attendant
4	376J00000X	Homemaker

General Provider Information

NPI Number	:	1558966952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL BETH WAY

Provider Business Mailing Address
First Line	:	1601 FRUITLAND AVE
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-3403
Country	:	US
Telephone Number	:	216-407-5614
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 FRUITLAND AVE
Second Line	:
City	:	MAYFIELD HEIGHTS
State	:	OH
Zip	:	44124-3403
Country	:	US
Telephone Number	:	216-407-5614
Fax Number	:

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

Provider Enumeration Date	:	12/02/2020
Last Update Date	:	12/02/2020

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Directions to “ RACHEL BETH WAY ” Practice Location

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