Provider Demographics
NPI:1912026055
Name:OHIO EASTERN STAR COMMUNITY SERVICES
Entity Type:Organization
Organization Name:OHIO EASTERN STAR COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZANDRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:740-397-1706
Mailing Address - Street 1:1451 GAMBIER ROAD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-9299
Mailing Address - Country:US
Mailing Address - Phone:704-397-1706
Mailing Address - Fax:740-392-1662
Practice Address - Street 1:1451 GAMBIER ROAD
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-9299
Practice Address - Country:US
Practice Address - Phone:704-397-1706
Practice Address - Fax:740-392-1662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health