1891250833 NPI number — FOREVER FAITHFUL HOME HEALTHCARE AGENCY LLC

Table of content: (NPI 1891250833)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891250833 NPI number — FOREVER FAITHFUL HOME HEALTHCARE AGENCY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FOREVER FAITHFUL HOME HEALTHCARE AGENCY LLC
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:
FOREVER FAITHFUL HOME HEALTHCARE
Provider Other Organization Name Type Code:
3
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:
1891250833
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/25/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9882 VOYAGER WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45252-1992
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-323-1222
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9882 VOYAGER WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45252-1992
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-323-1222
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/04/2019

Additional Information

Authorized Official

Authorized Official Last Name:
FOREMAN
Authorized Official First Name:
OSCAR
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF BUSINESS MANAGEMENT
Authorized Official Telephone Number:
513-407-5737

Provider Taxonomy Codes

  • Taxonomy code: 104100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 172A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 310400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3104A0630X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 372500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 374U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 376J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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