Provider Demographics
NPI:1689655037
Name:SUMNER SKILLED SERVICES
Entity Type:Organization
Organization Name:SUMNER SKILLED SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD OF TRUSTEES PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-664-1315
Mailing Address - Street 1:970 SUMNER PKWY
Mailing Address - Street 2:
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321-1693
Mailing Address - Country:US
Mailing Address - Phone:330-664-1370
Mailing Address - Fax:330-664-1375
Practice Address - Street 1:970 SUMNER PKWY
Practice Address - Street 2:
Practice Address - City:COPLEY
Practice Address - State:OH
Practice Address - Zip Code:44321-1693
Practice Address - Country:US
Practice Address - Phone:330-664-1370
Practice Address - Fax:330-664-1375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH368090251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2548176Medicaid
OH368090Medicare ID - Type UnspecifiedMEDICARE HOME HEALTH