MEDICARE: MRS. BETTY R BESS SOLE PROVIDER

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	376J00000X	Homemaker		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	:	1568968980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BETTY R BESS SOLE PROVIDER

Provider Business Mailing Address
First Line	:	4944 FOXLAIR TRL
Second Line	:
City	:	RICHMOND HTS
State	:	OH
Zip	:	44143-2730
Country	:	US
Telephone Number	:	216-299-9280
Fax Number	:

Provider Business Practice Location Address
First Line	:	4944 FOXLAIR TRL
Second Line	:
City	:	RICHMOND HTS
State	:	OH
Zip	:	44143-2730
Country	:	US
Telephone Number	:	216-299-9280
Fax Number	:

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

Provider Enumeration Date	:	04/04/2018
Last Update Date	:	04/04/2018

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