Provider Demographics
NPI:1689873143
Name:TVC HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:TVC HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:MELILLO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MBA
Authorized Official - Phone:330-755-1110
Mailing Address - Street 1:224 MISTY WOODS CT
Mailing Address - Street 2:
Mailing Address - City:STRUTHERS
Mailing Address - State:OH
Mailing Address - Zip Code:44471-2188
Mailing Address - Country:US
Mailing Address - Phone:330-755-1110
Mailing Address - Fax:330-755-4070
Practice Address - Street 1:5130 YOUNGSTOWN POLAND RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44514-1265
Practice Address - Country:US
Practice Address - Phone:330-755-1110
Practice Address - Fax:330-755-4070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-15
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH90015379332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5965770001Medicare NSC