Provider Demographics
NPI:1124041892
Name:LIVINGSTON LOCKBOURNE HOME HEALTH AGENCY
Entity Type:Organization
Organization Name:LIVINGSTON LOCKBOURNE HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:RATLIFF
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:614-252-0917
Mailing Address - Street 1:1289 E LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2838
Mailing Address - Country:US
Mailing Address - Phone:614-252-0917
Mailing Address - Fax:614-252-6153
Practice Address - Street 1:1289 E LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2838
Practice Address - Country:US
Practice Address - Phone:614-252-0917
Practice Address - Fax:614-252-6153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health