MEDICARE: I TO I SUPPORTS, 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	347C00000X	Private Vehicle

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	:	1841534278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	I TO I SUPPORTS, LLC

Provider Business Mailing Address
First Line	:	PO BOX 9547
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43209-0547
Country	:	US
Telephone Number	:	614-252-5378
Fax Number	:

Provider Business Practice Location Address
First Line	:	1835 AGLER RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-4401
Country	:	US
Telephone Number	:	614-252-5378
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MIMI MORRIS
Credential	:
Telephone Number	:	614-805-1049

Provider Enumeration Date	:	11/26/2012
Last Update Date	:	11/26/2012

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Directions to “I TO I SUPPORTS, LLC ” Practice Location

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