MEDICARE: JERIMIAH IMMANUEL MCALPINE

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	374U00000X	Home Health Aide	VQ397933	OH

General Provider Information

NPI Number	:	1609668920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JERIMIAH IMMANUEL MCALPINE

Provider Business Mailing Address
First Line	:	4018 WILMINGTON RD
Second Line	:
City	:	SOUTH EUCLID
State	:	OH
Zip	:	44121-2618
Country	:	US
Telephone Number	:	216-659-0814
Fax Number	:

Provider Business Practice Location Address
First Line	:	4018 WILMINGTON RD
Second Line	:
City	:	SOUTH EUCLID
State	:	OH
Zip	:	44121-2618
Country	:	US
Telephone Number	:	216-659-0814
Fax Number	:

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

Provider Enumeration Date	:	05/21/2025
Last Update Date	:	05/21/2025

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