MEDICARE: AMY POOLER

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	172A00000X	Driver		OH
2	253Z00000X	In Home Supportive Care Agency		OH

General Provider Information

NPI Number	:	1962345298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY POOLER

Provider Business Mailing Address
First Line	:	456 MEADOW LN
Second Line	:
City	:	SPRINGFIELD
State	:	OH
Zip	:	45505-1659
Country	:	US
Telephone Number	:	937-206-7615
Fax Number	:

Provider Business Practice Location Address
First Line	:	456 MEADOW LN
Second Line	:
City	:	SPRINGFIELD
State	:	OH
Zip	:	45505-1659
Country	:	US
Telephone Number	:	937-206-7615
Fax Number	:

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

Provider Enumeration Date	:	04/11/2026
Last Update Date	:	04/11/2026

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Directions to “ AMY POOLER ” Practice Location

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