Provider Demographics
NPI:1952867665
Name:HEREFORD HEALTHCARE LLC
Entity Type:Organization
Organization Name:HEREFORD HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HEREFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-820-5378
Mailing Address - Street 1:5257 E FARNHURST RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-1239
Mailing Address - Country:US
Mailing Address - Phone:216-820-5378
Mailing Address - Fax:
Practice Address - Street 1:5257 E FARNHURST RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-1239
Practice Address - Country:US
Practice Address - Phone:216-820-5378
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-18
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health