MEDICARE: MISS ALMA ANN AUSTIN

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	171M00000X	Case Manager/Care Coordinator	2908901	OH

General Provider Information

NPI Number	:	1689800518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ALMA ANN AUSTIN

Provider Business Mailing Address
First Line	:	1228 DUXBERRY AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43211-2229
Country	:	US
Telephone Number	:	614-268-1763
Fax Number	:	614-268-1763

Provider Business Practice Location Address
First Line	:	1228 DUXBERRY AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43211-2229
Country	:	US
Telephone Number	:	614-268-1763
Fax Number	:	614-268-1763

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

Provider Enumeration Date	:	06/05/2009
Last Update Date	:	06/05/2009

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