MEDICARE: MS. RONDIE R LAMB

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
2	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1578150116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RONDIE R LAMB

Provider Business Mailing Address
First Line	:	721 BEECH AVE
Second Line	:
City	:	FORT SCOTT
State	:	KS
Zip	:	66701-2809
Country	:	US
Telephone Number	:	913-302-5539
Fax Number	:

Provider Business Practice Location Address
First Line	:	721 BEECH AVE
Second Line	:
City	:	FORT SCOTT
State	:	KS
Zip	:	66701-2809
Country	:	US
Telephone Number	:	913-302-5539
Fax Number	:

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

Provider Enumeration Date	:	12/29/2020
Last Update Date	:	02/18/2021

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Directions to “ MS. RONDIE R LAMB ” Practice Location

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