Provider Demographics
NPI:1356092555
Name:COUNTRY HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:COUNTRY HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BHIM
Authorized Official - Middle Name:M
Authorized Official - Last Name:SUBEDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-568-1414
Mailing Address - Street 1:8111 MANDALAY RD
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-9219
Mailing Address - Country:US
Mailing Address - Phone:614-973-3270
Mailing Address - Fax:614-701-9934
Practice Address - Street 1:10400 BLACKLICK EASTERN RD STE 110
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-7702
Practice Address - Country:US
Practice Address - Phone:614-568-1414
Practice Address - Fax:614-701-9934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care