MEDICARE: BRITTINEY GRIFFIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	253Z00000X	In Home Supportive Care Agency
2	374U00000X	Home Health Aide
3	251E00000X	Home Health 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	:	1629693130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTINEY GRIFFIN

Provider Business Mailing Address
First Line	:	3418 BURRELL DR
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40216-4373
Country	:	US
Telephone Number	:	502-744-8041
Fax Number	:

Provider Business Practice Location Address
First Line	:	3418 BURRELL DR
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40216-4373
Country	:	US
Telephone Number	:	502-744-8041
Fax Number	:

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

Provider Enumeration Date	:	06/10/2020
Last Update Date	:	06/10/2020

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