Provider Demographics
NPI:1093034340
Name:STATE HEALTH CARE LTD
Entity Type:Organization
Organization Name:STATE HEALTH CARE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-222-2537
Mailing Address - Street 1:201 RIVERSIDE DR STE 2E
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45405-4956
Mailing Address - Country:US
Mailing Address - Phone:937-222-2537
Mailing Address - Fax:937-222-2543
Practice Address - Street 1:201 RIVERSIDE DR STE 2E
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45405-4956
Practice Address - Country:US
Practice Address - Phone:937-222-2537
Practice Address - Fax:937-222-2543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH201013000811251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health