Provider Demographics
NPI:1235529595
Name:STONERISE HOME HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:STONERISE HOME HEALTH SERVICES LLC
Other - Org Name:STONERISE HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:STOLTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-489-7100
Mailing Address - Street 1:700 CHAPPELL RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-2704
Mailing Address - Country:US
Mailing Address - Phone:304-343-1950
Mailing Address - Fax:304-343-1947
Practice Address - Street 1:332 6TH AVE
Practice Address - Street 2:
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25303-1246
Practice Address - Country:US
Practice Address - Phone:304-757-9333
Practice Address - Fax:304-757-9336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV517132Medicare PIN