Provider Demographics
NPI:1518375344
Name:AMERIPASS HOME HEATHCARE LLC
Entity Type:Organization
Organization Name:AMERIPASS HOME HEATHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RONDA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:937-387-0200
Mailing Address - Street 1:330 JAMES BOHANAN DR
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:OH
Mailing Address - Zip Code:45377-2341
Mailing Address - Country:US
Mailing Address - Phone:937-387-0200
Mailing Address - Fax:937-387-0096
Practice Address - Street 1:330 JAMES BOHANAN DR
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:OH
Practice Address - Zip Code:45377-2341
Practice Address - Country:US
Practice Address - Phone:937-387-0200
Practice Address - Fax:937-387-0096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1659260251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0097936Medicaid