Provider Demographics
NPI:1477980720
Name:STREAMLINE TOTALCARE
Entity Type:Organization
Organization Name:STREAMLINE TOTALCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHAUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SETTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-367-7828
Mailing Address - Street 1:6415 E LIVINGSTON AVE SUITE C
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068
Mailing Address - Country:US
Mailing Address - Phone:614-367-7828
Mailing Address - Fax:614-367-1684
Practice Address - Street 1:6415 E LIVINGSTON AVE STE C
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068
Practice Address - Country:US
Practice Address - Phone:614-367-7828
Practice Address - Fax:614-367-1684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-02
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH022254850-033336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3021750Medicaid