Provider Demographics
NPI:1114622081
Name:BUCKEYES SERVICE LLC
Entity Type:Organization
Organization Name:BUCKEYES SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NOUROULDINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIALLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-663-0020
Mailing Address - Street 1:5452 ROHDEN DR
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-9121
Mailing Address - Country:US
Mailing Address - Phone:703-663-0020
Mailing Address - Fax:
Practice Address - Street 1:5452 ROHDEN DR
Practice Address - Street 2:
Practice Address - City:CANAL WINCHESTER
Practice Address - State:OH
Practice Address - Zip Code:43110-9121
Practice Address - Country:US
Practice Address - Phone:703-663-0020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health