MEDICARE: TERESA ANN ODEN

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	7717206	OH

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	:	1902484116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA ANN ODEN

Provider Business Mailing Address
First Line	:	399 EDITH AVE
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44312-3662
Country	:	US
Telephone Number	:	330-785-5345
Fax Number	:

Provider Business Practice Location Address
First Line	:	399 EDITH AVE
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44312-3662
Country	:	US
Telephone Number	:	330-785-5345
Fax Number	:

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

Provider Enumeration Date	:	03/30/2021
Last Update Date	:	03/30/2021

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Directions to “ TERESA ANN ODEN ” Practice Location

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