MEDICARE: ERIN SMITH

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	:	1902449226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN SMITH

Provider Business Mailing Address
First Line	:	1122 E 17TH ST
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27105-6178
Country	:	US
Telephone Number	:	336-734-8183
Fax Number	:

Provider Business Practice Location Address
First Line	:	1122 E 17TH ST
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27105-6178
Country	:	US
Telephone Number	:	336-734-8183
Fax Number	:

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

Provider Enumeration Date	:	10/18/2019
Last Update Date	:	10/18/2019

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Directions to “ ERIN SMITH ” Practice Location

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