1083693253 NPI number — PERSONAL TOUCH HOME CARE OF OHIO, INC

Table of content: (NPI 1083693253)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083693253 NPI number — PERSONAL TOUCH HOME CARE OF OHIO, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PERSONAL TOUCH HOME CARE OF OHIO, INC
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:
1083693253
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/09/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22215 NORTHERN BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAYSIDE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11361-3603
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-468-4747
Provider Business Mailing Address Fax Number:
718-264-5834

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3735 S DIXIE HWY
Provider Second Line Business Practice Location Address:
UNIT E
Provider Business Practice Location Address City Name:
FRANKLIN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45005-5713
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-727-3574
Provider Business Practice Location Address Fax Number:
513-727-4534
Provider Enumeration Date:
01/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LASKIN
Authorized Official First Name:
LORIGAY
Authorized Official Middle Name:
Authorized Official Title or Position:
CONTRACT MANAGER
Authorized Official Telephone Number:
718-468-4747

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2251236 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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