MEDICARE: FIDELITY HEALTH CARE INC

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	332B00000X	Durable Medical Equipment & Medical Supplies
2	335E00000X	Prosthetic/Orthotic Supplier

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	:	1639414063
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIDELITY HEALTH CARE INC

Provider Business Mailing Address
First Line	:	3832 KETTERING BLVD
Second Line	:
City	:	MORAINE
State	:	OH
Zip	:	45439-2017
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8385 N MAIN ST
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45415-1602
Country	:	US
Telephone Number	:	937-898-1566
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT & CFO
Name	:	PAULA THOMPSON
Credential	:
Telephone Number	:	937-208-6461

Provider Enumeration Date	:	12/12/2012
Last Update Date	:	08/19/2013

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Directions to “FIDELITY HEALTH CARE INC ” Practice Location

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