MEDICARE: INTERNATIONAL ELDERLY CARE GROUP LLC

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	385H00000X	Respite Care

General Provider Information

NPI Number	:	1700023355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERNATIONAL ELDERLY CARE GROUP LLC

Provider Business Mailing Address
First Line	:	3515 SPRINGDALE RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45251-1300
Country	:	US
Telephone Number	:	513-741-9800
Fax Number	:

Provider Business Practice Location Address
First Line	:	7369 BROOKCREST DR STE B
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-3407
Country	:	US
Telephone Number	:	513-293-6500
Fax Number	:

Authorized Official
Title or Position	:	GENERAL COUNSEL
Name	:	MICHAEL GEORGE SHARIFF
Credential	:	ESQ
Telephone Number	:	513-741-9800

Provider Enumeration Date	:	01/18/2009
Last Update Date	:	02/26/2010

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