MEDICARE: ANJALIA EGGLESTON

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1932835758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANJALIA EGGLESTON

Provider Business Mailing Address
First Line	:	13308 6TH AVE
Second Line	:
City	:	EAST CLEVELAND
State	:	OH
Zip	:	44112-3140
Country	:	US
Telephone Number	:	216-704-0499
Fax Number	:

Provider Business Practice Location Address
First Line	:	13308 6TH AVE
Second Line	:
City	:	EAST CLEVELAND
State	:	OH
Zip	:	44112-3140
Country	:	US
Telephone Number	:	216-704-0499
Fax Number	:

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

Provider Enumeration Date	:	07/25/2022
Last Update Date	:	07/25/2022

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Directions to “ ANJALIA EGGLESTON ” Practice Location

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