MEDICARE: GLENEICE PHILLIPS

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		OH

General Provider Information

NPI Number	:	1720939432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLENEICE PHILLIPS

Provider Business Mailing Address
First Line	:	2620 HOME AVE STE A
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45417-2118
Country	:	US
Telephone Number	:	219-910-7302
Fax Number	:

Provider Business Practice Location Address
First Line	:	2620 HOME AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45417-2118
Country	:	US
Telephone Number	:	219-910-7302
Fax Number	:

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

Provider Enumeration Date	:	02/07/2026
Last Update Date	:	03/19/2026

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Directions to “ GLENEICE PHILLIPS ” Practice Location

Language	Start Address	Practice Location

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