MEDICARE: AMBER 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1922839919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER SMITH

Provider Business Mailing Address
First Line	:	1033 SHINKLE RIDGE RD
Second Line	:
City	:	GEORGETOWN
State	:	OH
Zip	:	45121-9728
Country	:	US
Telephone Number	:	937-618-0644
Fax Number	:

Provider Business Practice Location Address
First Line	:	947 SHINKLE RIDGE RD
Second Line	:
City	:	GEORGETOWN
State	:	OH
Zip	:	45121-9797
Country	:	US
Telephone Number	:	937-213-3781
Fax Number	:

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

Provider Enumeration Date	:	08/12/2024
Last Update Date	:	08/12/2024

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Directions to “ AMBER SMITH ” Practice Location

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