Provider Demographics
NPI:1790790285
Name:HEALTH II OHIO, LLC
Entity Type:Organization
Organization Name:HEALTH II OHIO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTICE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:480-315-8607
Mailing Address - Street 1:8723 E VIA DE COMMERCIO
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-3328
Mailing Address - Country:US
Mailing Address - Phone:480-315-8607
Mailing Address - Fax:480-315-8796
Practice Address - Street 1:3246 NAVARRE AVE
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3395
Practice Address - Country:US
Practice Address - Phone:419-423-9003
Practice Address - Fax:419-425-1575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH48175471332B00000X
OH332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH23626OtherABP
OH2461590Medicaid
OH81700OtherNORTHWOOD
OH23626OtherABP