Provider Demographics
NPI:1053455022
Name:MID-OHIO HOME HEALTH SERVICES,LTD
Entity Type:Organization
Organization Name:MID-OHIO HOME HEALTH SERVICES,LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-529-3883
Mailing Address - Street 1:1332 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-1828
Mailing Address - Country:US
Mailing Address - Phone:419-529-3883
Mailing Address - Fax:419-529-0725
Practice Address - Street 1:1332 W 4TH ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-1828
Practice Address - Country:US
Practice Address - Phone:419-529-3883
Practice Address - Fax:419-529-0725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2175131Medicaid
OH367707Medicare ID - Type UnspecifiedMEDICARE