Provider Demographics
NPI:1235207135
Name:BUCKEYE HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:BUCKEYE HOME HEALTH SERVICES LLC
Other - Org Name:DBA BUCKEYE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BRUCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-781-0357
Mailing Address - Street 1:1565 BETHEL ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220
Mailing Address - Country:US
Mailing Address - Phone:614-781-0357
Mailing Address - Fax:614-781-0389
Practice Address - Street 1:1565 BETHEL ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220
Practice Address - Country:US
Practice Address - Phone:614-781-0357
Practice Address - Fax:614-781-0389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2516227Medicaid
OH368067Medicaid
OH2516227Medicare UPIN
OH368067Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER