Provider Demographics
NPI:1194523712
Name:MASUDI, JORDAN SALUMU
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:SALUMU
Last Name:MASUDI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1764 CULVER CT APT 10
Mailing Address - Street 2:
Mailing Address - City:AMELIA
Mailing Address - State:OH
Mailing Address - Zip Code:45102-2259
Mailing Address - Country:US
Mailing Address - Phone:513-501-3718
Mailing Address - Fax:
Practice Address - Street 1:334 S 400 E APT 13
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-3473
Practice Address - Country:US
Practice Address - Phone:513-501-3718
Practice Address - Fax:513-501-3718
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No251K00000XAgenciesPublic Health or WelfareGroup - Multi-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)