MEDICARE: ABUNDANCE COMPANION & HOME CARE

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

General Provider Information

NPI Number	:	1649769324
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABUNDANCE COMPANION & HOME CARE

Provider Business Mailing Address
First Line	:	2622 TAMPICO DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45231-2844
Country	:	US
Telephone Number	:	513-834-3445
Fax Number	:

Provider Business Practice Location Address
First Line	:	2622 TAMPICO DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45231-2844
Country	:	US
Telephone Number	:	513-834-3445
Fax Number	:

Authorized Official
Title or Position	:	STNA/ OWNER
Name	:	NASTACIA SHONTRELL BELL
Credential	:
Telephone Number	:	513-834-3445

Provider Enumeration Date	:	05/08/2018
Last Update Date	:	05/08/2018

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