Provider Demographics
NPI:1609520329
Name:PAC SERVICES LLC
Entity Type:Organization
Organization Name:PAC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MISS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEALS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-747-7668
Mailing Address - Street 1:5579 PEARL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-2555
Mailing Address - Country:US
Mailing Address - Phone:440-747-7668
Mailing Address - Fax:440-340-5758
Practice Address - Street 1:5579 PEARL RD STE 101
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-2555
Practice Address - Country:US
Practice Address - Phone:440-747-7668
Practice Address - Fax:440-340-5758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-10
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1825494Medicaid