MEDICARE: TONYA BENTLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	374U00000X	Home Health Aide
2	253Z00000X	In Home Supportive Care Agency
3	376J00000X	Homemaker

General Provider Information

NPI Number	:	1710604814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONYA BENTLEY

Provider Business Mailing Address
First Line	:	1461 E 22ND AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43211-2527
Country	:	US
Telephone Number	:	614-893-9422
Fax Number	:

Provider Business Practice Location Address
First Line	:	1461 E 22ND AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43211-2527
Country	:	US
Telephone Number	:	614-893-9422
Fax Number	:

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

Provider Enumeration Date	:	10/20/2022
Last Update Date	:	10/20/2022

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Directions to “ TONYA BENTLEY ” Practice Location

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