MEDICARE: MS. MARY HOPKINS

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	372600000X	Adult Companion	0000014346	OH

General Provider Information

NPI Number	:	1881307122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARY HOPKINS

Provider Business Mailing Address
First Line	:	PO BOX 605165
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44105-0165
Country	:	US
Telephone Number	:	216-760-4377
Fax Number	:

Provider Business Practice Location Address
First Line	:	3526 E 103RD ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44105-1812
Country	:	US
Telephone Number	:	216-760-4377
Fax Number	:

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

Provider Enumeration Date	:	01/02/2023
Last Update Date	:	01/02/2023

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