Provider Demographics
NPI:1598061418
Name:PATRIOT HOMECARE, INC.
Entity Type:Organization
Organization Name:PATRIOT HOMECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-306-9651
Mailing Address - Street 1:986 TIBBETTS WICK RD
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:OH
Mailing Address - Zip Code:44420-1120
Mailing Address - Country:US
Mailing Address - Phone:330-306-9651
Mailing Address - Fax:330-395-0133
Practice Address - Street 1:986 TIBBETTS WICK RD
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:OH
Practice Address - Zip Code:44420-1120
Practice Address - Country:US
Practice Address - Phone:330-306-9651
Practice Address - Fax:330-539-9213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-10
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0068264Medicaid