MEDICARE: ORALE MANAGEMENT GROUP 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1891579520
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORALE MANAGEMENT GROUP LLC

Provider Business Mailing Address
First Line	:	PO BOX 90743
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85752-0743
Country	:	US
Telephone Number	:	520-390-9151
Fax Number	:

Provider Business Practice Location Address
First Line	:	5035 W PHEASANT ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85742-9456
Country	:	US
Telephone Number	:	520-390-9151
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	TRACI WILLIAMS-RAYMOND
Credential	:	BSN, RN
Telephone Number	:	520-390-9151

Provider Enumeration Date	:	08/23/2023
Last Update Date	:	08/24/2023

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