Provider Demographics
NPI:1053460881
Name:INTERIM HEALTHCARE OF NORTHWESTERN OHIO, INC.
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE OF NORTHWESTERN OHIO, INC.
Other - Org Name:INTERIM HEALTHCARE OF LIMA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIMARCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-436-9404
Mailing Address - Street 1:3745 SHAWNEE RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45806-1657
Mailing Address - Country:US
Mailing Address - Phone:419-228-2535
Mailing Address - Fax:419-227-9244
Practice Address - Street 1:3745 SHAWNEE RD
Practice Address - Street 2:SUITE 108
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45806-1657
Practice Address - Country:US
Practice Address - Phone:419-228-2535
Practice Address - Fax:419-227-9244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0540141Medicaid
OH367208Medicare UPIN