Pamela Ann Burroughs
Individual provider Active NPI Home Health Aide · Avon Lake, OH
NPI 1619099298 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1619099298
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Aide 374U00000X
- Practice address
- 601 Treeside LN
Avon Lake, OH 44012-2750 - Phone
- (440) 336-7002
- NPI assigned
- Apr 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | Yes |
Addresses
Primary practice location
601 Treeside LN
Avon Lake, OH 44012-2750
Mailing address
2838 Northview Rd
Rocky River, OH 44116-3523
Phone (440) 336-7002
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2302412 | Medicaid | OH |
Other providers in Avon Lake, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.