Provider Demographics
NPI:1285857938
Name:OHIO SENIORSUPPORT
Entity Type:Organization
Organization Name:OHIO SENIORSUPPORT
Other - Org Name:OHIO SENIOR SUPPORT HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:614-818-9336
Mailing Address - Street 1:855 S SUNBURY RD STE 202
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-9553
Mailing Address - Country:US
Mailing Address - Phone:614-818-9336
Mailing Address - Fax:
Practice Address - Street 1:1207 COLSTON DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-3685
Practice Address - Country:US
Practice Address - Phone:614-818-9336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health