Provider Demographics
NPI:1437519527
Name:PRESTIGE HOMEHEALTH SERVICES LLC
Entity Type:Organization
Organization Name:PRESTIGE HOMEHEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:ASHU
Authorized Official - Last Name:TATAW-BIAKA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:419-787-1425
Mailing Address - Street 1:247 FOX GLEN DR E
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-7798
Mailing Address - Country:US
Mailing Address - Phone:419-787-1425
Mailing Address - Fax:
Practice Address - Street 1:247 FOX GLEN DR E
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-7798
Practice Address - Country:US
Practice Address - Phone:419-787-1425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-02
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3864225251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health