Provider Demographics
NPI:1396845368
Name:INTERIM HEALTHCARE OF CAMBRIDGE INC
Entity Type:Organization
Organization Name:INTERIM HEALTHCARE OF CAMBRIDGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIMARCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-436-9404
Mailing Address - Street 1:2146 SOUTHGATE PKWY
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-3096
Mailing Address - Country:US
Mailing Address - Phone:740-432-2966
Mailing Address - Fax:740-439-2599
Practice Address - Street 1:2146 SOUTHGATE PKWY
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-3096
Practice Address - Country:US
Practice Address - Phone:740-432-2966
Practice Address - Fax:740-439-2599
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTERIM HEALTHCARE CAMBRIDGE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-22
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0754750Medicaid
OH2372089Medicaid
OH367324Medicare UPIN