MEDICARE: JSHAWN JOMAR MCLENDON LPN

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)	TX380410	OH

General Provider Information

NPI Number	:	1831889450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JSHAWN JOMAR MCLENDON LPN

Provider Business Mailing Address
First Line	:	2612 ANDERSON PL SW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44710-2162
Country	:	US
Telephone Number	:	234-203-9998
Fax Number	:

Provider Business Practice Location Address
First Line	:	2612 ANDERSON PL SW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44710-2162
Country	:	US
Telephone Number	:	234-203-9998
Fax Number	:

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

Provider Enumeration Date	:	05/08/2023
Last Update Date	:	05/08/2023

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