Provider Demographics
NPI:1396358941
Name:TRULY PEDIATRIC HOME CARE LLC
Entity Type:Organization
Organization Name:TRULY PEDIATRIC HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARCHELLE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HOPSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:937-397-3600
Mailing Address - Street 1:3639 GREENBAY DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-2018
Mailing Address - Country:US
Mailing Address - Phone:937-397-3600
Mailing Address - Fax:937-742-7262
Practice Address - Street 1:3639 GREENBAY DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-2018
Practice Address - Country:US
Practice Address - Phone:937-397-3600
Practice Address - Fax:937-742-7262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care