Basic Information
| Provider Information | |||||||||
| NPI: | 1457350787 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | FAMILY NURSING SERVICES, INC. | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 24 STAR DR. | ||||||||
| Address2: | |||||||||
| City: | CHILLICOTHE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7407755463 | ||||||||
| FaxNumber: | 7407755464 | ||||||||
| Practice Location | |||||||||
| Address1: | 24 STAR DR. | ||||||||
| Address2: | |||||||||
| City: | CHILLICOTHE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7407755463 | ||||||||
| FaxNumber: | 7407755464 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2005 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | RUSH | ||||||||
| AuthorizedOfficialFirstName: | RANDY | ||||||||
| AuthorizedOfficialMiddleName: | K. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7407755463 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | OH | Y | Agencies | Home Health |
ID Information
| ID | Type | State | Issuer | Description | 0781033 | 05 | OH | MEDICAID | 0835323 | 01 | OH | WAIVER IV | OTHER |