Provider Demographics
NPI:1619332012
Name:CORDIAL HOME HEALTH CARE SERVICES LLC
Entity Type:Organization
Organization Name:CORDIAL HOME HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PRATIBHA
Authorized Official - Middle Name:
Authorized Official - Last Name:NIGAM
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LLB, LPN
Authorized Official - Phone:937-431-0905
Mailing Address - Street 1:3055 RODENBECK DR
Mailing Address - Street 2:SUITE 4B
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45432-2699
Mailing Address - Country:US
Mailing Address - Phone:937-371-0700
Mailing Address - Fax:
Practice Address - Street 1:3055 RODENBECK DR
Practice Address - Street 2:SUITE 4B
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45432-2699
Practice Address - Country:US
Practice Address - Phone:937-371-0700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-29
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH141214251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health