Provider Demographics
NPI:1326765470
Name:DYSERV, INC
Entity Type:Organization
Organization Name:DYSERV, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-294-6078
Mailing Address - Street 1:1144 GOODALE BLVD
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-3728
Mailing Address - Country:US
Mailing Address - Phone:614-294-6078
Mailing Address - Fax:614-294-6315
Practice Address - Street 1:1144 GOODALE BLVD
Practice Address - Street 2:
Practice Address - City:GRANDVIEW HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:43212-3728
Practice Address - Country:US
Practice Address - Phone:614-294-6078
Practice Address - Fax:614-294-6315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health