MEDICARE: DEBORAH L SMITH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	171W00000X	Contractor	OH
2	251E00000X	Home Health Agency	OH
3	376J00000X	Homemaker	OH
4	253Z00000X	In Home Supportive Care Agency	OH

General Provider Information

NPI Number	:	1992303622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH L SMITH

Provider Business Mailing Address
First Line	:	11 E RANDY ST
Second Line	:
City	:	NEW FRANKLIN
State	:	OH
Zip	:	44203-4820
Country	:	US
Telephone Number	:	330-592-7724
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 E RANDY ST
Second Line	:
City	:	NEW FRANKLIN
State	:	OH
Zip	:	44203-4820
Country	:	US
Telephone Number	:	330-592-7724
Fax Number	:

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

Provider Enumeration Date	:	10/14/2020
Last Update Date	:	10/14/2020

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Directions to “ DEBORAH L SMITH ” Practice Location

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