MEDICARE: COMMUNITY 333

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	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1619835717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY 333

Provider Business Mailing Address
First Line	:	755 E WHITTIER ST APT 304
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43206-2990
Country	:	US
Telephone Number	:	380-215-8786
Fax Number	:	380-215-8786

Provider Business Practice Location Address
First Line	:	755 E WHITTIER ST APT 304
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43206-2990
Country	:	US
Telephone Number	:	380-215-8786
Fax Number	:	380-215-8786

Authorized Official
Title or Position	:	MANAGER
Name	:	MS. SYMONE NADINE SMITH
Credential	:
Telephone Number	:	380-215-8786

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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Directions to “COMMUNITY 333 ” Practice Location

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