MEDICARE: SIRJO SEPH WELCH

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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1780216994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIRJO SEPH WELCH

Provider Business Mailing Address
First Line	:	8330 REYNOLDSWOOD DR
Second Line	:
City	:	REYNOLDSBURG
State	:	OH
Zip	:	43068-9334
Country	:	US
Telephone Number	:	614-625-0535
Fax Number	:

Provider Business Practice Location Address
First Line	:	8330 REYNOLDSWOOD DR
Second Line	:
City	:	REYNOLDSBURG
State	:	OH
Zip	:	43068-9334
Country	:	US
Telephone Number	:	614-625-0535
Fax Number	:

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

Provider Enumeration Date	:	02/05/2020
Last Update Date	:	02/05/2020

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Directions to “ SIRJO SEPH WELCH ” Practice Location

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