MEDICARE: SHADEL LAMB & ASSOCIATES LLC

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	261QA0600X	Adult Day Care Clinic/Center	PN115186-MEDS	OH

General Provider Information

NPI Number	:	1801194246
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHADEL LAMB & ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	2823 QUEENSWOOD DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-8309
Country	:	US
Telephone Number	:	513-546-5595
Fax Number	:	513-931-2207

Provider Business Practice Location Address
First Line	:	4820 RIDGE AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45209-1033
Country	:	US
Telephone Number	:	513-546-5595
Fax Number	:	513-931-2207

Authorized Official
Title or Position	:	LPN
Name	:	MRS. SHADEL MARKISE LAMB
Credential	:
Telephone Number	:	513-546-5595

Provider Enumeration Date	:	03/09/2011
Last Update Date	:	03/09/2011

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