MEDICARE: BRANDON METROFF

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629559166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDON METROFF

Provider Business Mailing Address
First Line	:	1823 BOND ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43605-3709
Country	:	US
Telephone Number	:	419-265-8626
Fax Number	:

Provider Business Practice Location Address
First Line	:	1524 CARLYLE ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43605-3804
Country	:	US
Telephone Number	:	419-265-8626
Fax Number	:

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

Provider Enumeration Date	:	08/23/2018
Last Update Date	:	08/23/2018

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Directions to “ BRANDON METROFF ” Practice Location

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