Provider Demographics
NPI: | 1518366681 |
---|---|
Name: | CHI NATIONAL HOME CARE, LLC |
Entity Type: | Organization |
Organization Name: | CHI NATIONAL HOME CARE, LLC |
Other - Org Name: | CHI ST. VINCENT HEALTH AT HOME |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | V.P. FINANCE & CFO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JACK |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HAWKINS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 513-576-8478 |
Mailing Address - Street 1: | 6281 TRI RIDGE BLVD STE 300 |
Mailing Address - Street 2: | |
Mailing Address - City: | LOVELAND |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 45140-8345 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 513-576-0262 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 220 MCAULEY CT |
Practice Address - Street 2: | |
Practice Address - City: | HOT SPRINGS |
Practice Address - State: | AR |
Practice Address - Zip Code: | 71913-6312 |
Practice Address - Country: | US |
Practice Address - Phone: | 501-318-6800 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2014-08-14 |
Last Update Date: | 2022-12-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251E00000X | Agencies | Home Health |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
AR | 04-7006 | Medicare PIN |