Provider Demographics
NPI:1659003796
Name:BUCKEYE ANGELS HOME CARE LLC
Entity Type:Organization
Organization Name:BUCKEYE ANGELS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAFAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ABUSHAQRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-626-1403
Mailing Address - Street 1:4487 MARIE DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-6249
Mailing Address - Country:US
Mailing Address - Phone:937-626-1403
Mailing Address - Fax:
Practice Address - Street 1:4487 MARIE DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-6249
Practice Address - Country:US
Practice Address - Phone:937-626-1403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health