MEDICARE: NATASHA MILDRED HAMM

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	251E00000X	Home Health Agency	RT086943	OH

General Provider Information

NPI Number	:	1700486990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATASHA MILDRED HAMM

Provider Business Mailing Address
First Line	:	1410 PEACH BLOSSOM CT
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204-1621
Country	:	US
Telephone Number	:	614-817-8260
Fax Number	:

Provider Business Practice Location Address
First Line	:	4806 KINGSHILL DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-6204
Country	:	US
Telephone Number	:	614-781-0854
Fax Number	:

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

Provider Enumeration Date	:	10/28/2020
Last Update Date	:	10/28/2020

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