Provider Demographics
NPI:1407039902
Name:AMY SMIGELSKI
Entity Type:Organization
Organization Name:AMY SMIGELSKI
Other - Org Name:HEALTHY INDEPENDENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMIGELSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-940-4946
Mailing Address - Street 1:9821 OLDE 8 RD
Mailing Address - Street 2:D2
Mailing Address - City:NORTHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44067-1468
Mailing Address - Country:US
Mailing Address - Phone:866-940-4946
Mailing Address - Fax:866-940-4947
Practice Address - Street 1:9821 OLDE 8 RD
Practice Address - Street 2:D2
Practice Address - City:NORTHFIELD
Practice Address - State:OH
Practice Address - Zip Code:44067-1468
Practice Address - Country:US
Practice Address - Phone:866-940-4946
Practice Address - Fax:866-940-4947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2842777Medicaid
OH2842777Medicaid