Provider Demographics
NPI:1184841090
Name:SELECTIVE NETWORKING INC.
Entity Type:Organization
Organization Name:SELECTIVE NETWORKING INC.
Other - Org Name:ALTERNATIVE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADM, CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:740-574-2682
Mailing Address - Street 1:8407 HAYPORT RD
Mailing Address - Street 2:P.O. BOX 448
Mailing Address - City:WHEELERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45694-1832
Mailing Address - Country:US
Mailing Address - Phone:740-574-2682
Mailing Address - Fax:
Practice Address - Street 1:8407 HAYPORT RD
Practice Address - Street 2:
Practice Address - City:WHEELERSBURG
Practice Address - State:OH
Practice Address - Zip Code:45694-1832
Practice Address - Country:US
Practice Address - Phone:740-574-2682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPASSPORT 412196251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH412196OtherPASSPORT ID #