Provider Demographics
NPI:1093886442
Name:UNIVERSAL HOMECARE OF CINCINNATI LLC
Entity Type:Organization
Organization Name:UNIVERSAL HOMECARE OF CINCINNATI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:ROOKARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-352-7555
Mailing Address - Street 1:PO BOX 1882
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44309-1882
Mailing Address - Country:US
Mailing Address - Phone:513-362-2759
Mailing Address - Fax:513-362-2759
Practice Address - Street 1:1634 CENTRAL PKWY
Practice Address - Street 2:SUITE 116
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-6904
Practice Address - Country:US
Practice Address - Phone:513-362-2759
Practice Address - Fax:513-784-0812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health