Provider Demographics
NPI:1578700415
Name:DISTINGUISHED HEALTHCARE, LLC
Entity Type:Organization
Organization Name:DISTINGUISHED HEALTHCARE, LLC
Other - Org Name:DISTINGUISHED HEALTHCARE, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:740-503-0744
Mailing Address - Street 1:117 W MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-3799
Mailing Address - Country:US
Mailing Address - Phone:740-503-0744
Mailing Address - Fax:
Practice Address - Street 1:117 W MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3799
Practice Address - Country:US
Practice Address - Phone:740-503-0744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health