1306849278 NPI number — MEDCENTRAL HOMECARE AND HOSPICE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306849278 NPI number — MEDCENTRAL HOMECARE AND HOSPICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEDCENTRAL HOMECARE AND HOSPICE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306849278
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
335 GLESSNER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANSFIELD
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44903-2269
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-526-8442
Provider Business Mailing Address Fax Number:
419-756-2298

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1020 CRICKET LN
Provider Second Line Business Practice Location Address:
LOWR LEVEL
Provider Business Practice Location Address City Name:
MANSFIELD
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44906-4104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-526-8442
Provider Business Practice Location Address Fax Number:
419-756-2298
Provider Enumeration Date:
05/24/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ALSLEBEN
Authorized Official First Name:
MARTE
Authorized Official Middle Name:
D
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
419-526-8442

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  251E00000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)