Provider Demographics
NPI:1770186512
Name:BUCKEYE HOME MODIFICATIONS LLC
Entity Type:Organization
Organization Name:BUCKEYE HOME MODIFICATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSI
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:WEAVER-KRANZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-466-1953
Mailing Address - Street 1:6030 STATE ROUTE 754
Mailing Address - Street 2:
Mailing Address - City:MILLERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44654-8442
Mailing Address - Country:US
Mailing Address - Phone:330-466-1953
Mailing Address - Fax:
Practice Address - Street 1:6030 STATE ROUTE 754
Practice Address - Street 2:
Practice Address - City:MILLERSBURG
Practice Address - State:OH
Practice Address - Zip Code:44654-8442
Practice Address - Country:US
Practice Address - Phone:330-466-1953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty