MEDICARE: GOLLI ENTERPRISES LLC

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1578860268
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLLI ENTERPRISES LLC

Provider Business Mailing Address
First Line	:	7123 PEARL RD STE 102
Second Line	:
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-4944
Country	:	US
Telephone Number	:	440-202-1706
Fax Number	:	440-625-4142

Provider Business Practice Location Address
First Line	:	7123 PEARL RD STE 102
Second Line	:
City	:	MIDDLEBURG HEIGHTS
State	:	OH
Zip	:	44130-4944
Country	:	US
Telephone Number	:	440-202-1706
Fax Number	:	440-625-4142

Authorized Official
Title or Position	:	OWNER
Name	:	THOMAS GOLLI
Credential	:
Telephone Number	:	216-973-1869

Provider Enumeration Date	:	02/16/2011
Last Update Date	:	03/28/2022

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Directions to “GOLLI ENTERPRISES LLC ” Practice Location

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