MEDICARE: BY YOUR SIDE HOMECARE

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	302R00000X	Health Maintenance Organization

General Provider Information

NPI Number	:	1588114821
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BY YOUR SIDE HOMECARE

Provider Business Mailing Address
First Line	:	1818 GARDEN LN
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-5722
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1818 GARDEN LN
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-5722
Country	:	US
Telephone Number	:	513-680-3918
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	RYAN BRADLEY
Credential	:
Telephone Number	:	513-680-3918

Provider Enumeration Date	:	10/11/2016
Last Update Date	:	10/11/2016

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Directions to “BY YOUR SIDE HOMECARE ” Practice Location

Language	Start Address	Practice Location

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