Provider Demographics
NPI:1710581624
Name:BED BUG HOME PREPARATION SERVICE
Entity Type:Organization
Organization Name:BED BUG HOME PREPARATION SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-931-8371
Mailing Address - Street 1:1895 BASSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-4286
Mailing Address - Country:US
Mailing Address - Phone:330-931-8371
Mailing Address - Fax:330-563-4799
Practice Address - Street 1:1895 BASSWOOD DR
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-4286
Practice Address - Country:US
Practice Address - Phone:330-931-8371
Practice Address - Fax:330-563-4799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0125921Medicaid