Basic Information
| Provider Information | |||||||||
| NPI: | 1902291586 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CHI NATIONAL HOME CARE | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
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| OtherOrganizationName: | CHI ST. ANTHONY HEALTH AT HOME | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1700 EDISON DR | ||||||||
| Address2: | |||||||||
| City: | MILFORD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 451502729 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5135760262 | ||||||||
| FaxNumber: | 5135764388 | ||||||||
| Practice Location | |||||||||
| Address1: | 1416 SE COURT AVE | ||||||||
| Address2: | |||||||||
| City: | PENDLETON | ||||||||
| State: | OR | ||||||||
| PostalCode: | 978013215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5412764100 | ||||||||
| FaxNumber: | 5412786564 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2015 | ||||||||
| LastUpdateDate: | 04/01/2015 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | HERDTNER | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
| AuthorizedOfficialMiddleName: | S. | ||||||||
| AuthorizedOfficialTitleorPosition: | V.P. FINANCE & CFO | ||||||||
| AuthorizedOfficialTelephone: | 5135760262 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | Y | Agencies | Home Health |
No ID Information.