Provider Demographics
NPI:1790771624
Name:S & B HEALTHCARE, INC
Entity Type:Organization
Organization Name:S & B HEALTHCARE, INC
Other - Org Name:BLACK STONE HOME HEALHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAMONTANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-424-1370
Mailing Address - Street 1:3044 KETTERING BLVD
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-1922
Mailing Address - Country:US
Mailing Address - Phone:937-424-1370
Mailing Address - Fax:937-424-1372
Practice Address - Street 1:3044 KETTERING BLVD
Practice Address - Street 2:
Practice Address - City:MORAINE
Practice Address - State:OH
Practice Address - Zip Code:45439-1922
Practice Address - Country:US
Practice Address - Phone:937-424-1370
Practice Address - Fax:937-424-1372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-26
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH03543251E00000X
OHOH01179251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2467914Medicaid
OH368050Medicare Oscar/Certification
OH367296Medicare Oscar/Certification