Provider Demographics
NPI:1629592282
Name:NATIONAL CHURCH RESIDENCES - BARNESVILLE
Entity Type:Organization
Organization Name:NATIONAL CHURCH RESIDENCES - BARNESVILLE
Other - Org Name:NATIONAL CHURCH RESIDENCES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VP OF FOUNDATIONS
Authorized Official - Prefix:
Authorized Official - First Name:VAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:AMBROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-273-3505
Mailing Address - Street 1:2335 N BANK DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-5423
Mailing Address - Country:US
Mailing Address - Phone:740-273-3500
Mailing Address - Fax:614-451-0351
Practice Address - Street 1:485 NORTH ST
Practice Address - Street 2:
Practice Address - City:BARNESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43713-1105
Practice Address - Country:US
Practice Address - Phone:740-425-9001
Practice Address - Fax:740-619-0283
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL CHURCH RESIDENCES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)