MEDICARE: CAROL ARNOLD

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	374U00000X	Home Health Aide

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760606131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL ARNOLD

Provider Business Mailing Address
First Line	:	8605 UPPER TWIN RD.
Second Line	:
City	:	LEESBURG
State	:	OH
Zip	:	45681
Country	:	US
Telephone Number	:	740-626-2646
Fax Number	:

Provider Business Practice Location Address
First Line	:	298 EASTERN AVE.
Second Line	:
City	:	LEESBURG
State	:	OH
Zip	:	45135
Country	:	US
Telephone Number	:	937-780-2201
Fax Number	:

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

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	07/08/2007

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