Provider Demographics
NPI:1891118543
Name:THE BALLEW CORPORATION LLC
Entity Type:Organization
Organization Name:THE BALLEW CORPORATION LLC
Other - Org Name:CORE HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BALLEW
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:513-375-4275
Mailing Address - Street 1:4504 LUCERNE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-2816
Mailing Address - Country:US
Mailing Address - Phone:513-258-9789
Mailing Address - Fax:
Practice Address - Street 1:4504 LUCERNE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-2816
Practice Address - Country:US
Practice Address - Phone:513-258-9789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE BALLEW CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-31
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health