Provider Demographics
NPI:1346841020
Name:STARCHER, TOMMY A
Entity Type:Individual
Prefix:MR
First Name:TOMMY
Middle Name:A
Last Name:STARCHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 LILLIAN RD
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-2538
Mailing Address - Country:US
Mailing Address - Phone:330-524-0103
Mailing Address - Fax:
Practice Address - Street 1:1748 LILLIAN RD
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-2539
Practice Address - Country:US
Practice Address - Phone:330-524-0103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-08
Last Update Date:2020-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider