Provider Demographics
NPI:1588642540
Name:GREAT NURSING CARE, INC.
Entity Type:Organization
Organization Name:GREAT NURSING CARE, INC.
Other - Org Name:GOOD NURSING CARE, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:BOLTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-864-8150
Mailing Address - Street 1:1653 BRICE ROAD
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068
Mailing Address - Country:US
Mailing Address - Phone:614-864-8150
Mailing Address - Fax:614-866-9857
Practice Address - Street 1:1653 BRICE ROAD
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068
Practice Address - Country:US
Practice Address - Phone:614-864-8150
Practice Address - Fax:614-866-9857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-09
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2317951Medicaid
OH2317951Medicaid