Provider Demographics
NPI:1659718666
Name:ANNIE'S AIDE SERVICE
Entity Type:Organization
Organization Name:ANNIE'S AIDE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOME CARE AIDE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MCCULLOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1937-217-2530
Mailing Address - Street 1:414 E MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:WEST UNION
Mailing Address - State:OH
Mailing Address - Zip Code:45693-1411
Mailing Address - Country:US
Mailing Address - Phone:937-217-2530
Mailing Address - Fax:
Practice Address - Street 1:414 E MULBERRY ST
Practice Address - Street 2:
Practice Address - City:WEST UNION
Practice Address - State:OH
Practice Address - Zip Code:45693-1411
Practice Address - Country:US
Practice Address - Phone:937-217-2530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-30
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health