Provider Demographics
NPI:1083982813
Name:RADIANT HOME HEALTHCARE
Entity Type:Organization
Organization Name:RADIANT HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:DURU
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:740-973-4370
Mailing Address - Street 1:1536 SCENIC VALLEY PL
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-8470
Mailing Address - Country:US
Mailing Address - Phone:740-777-1636
Mailing Address - Fax:
Practice Address - Street 1:1536 SCENIC VALLEY PL
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8470
Practice Address - Country:US
Practice Address - Phone:740-777-1636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH201133400614251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health