Basic Information
Provider Information
NPI: 1073283727
EntityType: 2
ReplacementNPI:  
OrganizationName: VISITING NURSE HOSPICE AND HEALTH CARE
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5855 MONROE ST
Address2:  
City: SYLVANIA
State: OH
PostalCode: 435602269
CountryCode: US
TelephoneNumber: 4192912273
FaxNumber: 4198859136
Practice Location
Address1: 5855 MONROE ST
Address2:  
City: SYLVANIA
State: OH
PostalCode: 435602269
CountryCode: US
TelephoneNumber: 4192912273
FaxNumber: 4198859136
Other Information
ProviderEnumerationDate: 09/15/2021
LastUpdateDate: 09/15/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ALLEN
AuthorizedOfficialFirstName: MARTIN
AuthorizedOfficialMiddleName: DAVID
AuthorizedOfficialTitleorPosition: DIRECTOR
AuthorizedOfficialTelephone: 4192525734
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/15/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251J00000X  Y AgenciesNursing Care 

No ID Information.


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