MEDICARE: PINNCLEAN HOME CARE

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

General Provider Information

NPI Number	:	1821636044
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PINNCLEAN HOME CARE

Provider Business Mailing Address
First Line	:	5450 BEECHMONT AVE APT 404
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45230-1131
Country	:	US
Telephone Number	:	646-667-5267
Fax Number	:

Provider Business Practice Location Address
First Line	:	5450 BEECHMONT AVE APT 404
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45230-1131
Country	:	US
Telephone Number	:	646-667-5267
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PINDA NIANG
Credential	:
Telephone Number	:	646-667-5267

Provider Enumeration Date	:	12/18/2019
Last Update Date	:	12/18/2019

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