Provider Demographics
NPI:1326406646
Name:DONNA M SCARBERRY
Entity Type:Organization
Organization Name:DONNA M SCARBERRY
Other - Org Name:DONNA M SCARBERRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NON AGENCY PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCARBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-444-3623
Mailing Address - Street 1:38268 WOLF PEN RD
Mailing Address - Street 2:
Mailing Address - City:POMEROY
Mailing Address - State:OH
Mailing Address - Zip Code:45769-9506
Mailing Address - Country:US
Mailing Address - Phone:740-444-3623
Mailing Address - Fax:
Practice Address - Street 1:38268 WOLF PEN RD
Practice Address - Street 2:
Practice Address - City:POMEROY
Practice Address - State:OH
Practice Address - Zip Code:45769-9506
Practice Address - Country:US
Practice Address - Phone:740-444-3623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DONNA M SCARBERRY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0103001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0103011Medicaid