1760522742 NPI number — FIRST CHOICE HOME HEALTH OHIO INC

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 1760522742 NPI number — FIRST CHOICE HOME HEALTH OHIO INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FIRST CHOICE HOME HEALTH 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:
6
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:
1760522742
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5344 MEADOW LANE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHEFFIELD VILLAGE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44035-1469
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-934-2683
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1604 E PERKINS AVE
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
SANDUSKY
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44870-5178
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-626-9740
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SHAFFER
Authorized Official First Name:
LEONARD
Authorized Official Middle Name:
Authorized Official Title or Position:
CORPORATE DIRECTOR
Authorized Official Telephone Number:
440-934-2683

Provider Taxonomy Codes

  • Taxonomy code: 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)

  • Identifier: 2280339 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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