Provider Demographics
NPI:1992858732
Name:STORER, GAIL ANN (HOME HEALTH AIDE)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:ANN
Last Name:STORER
Suffix:
Gender:F
Credentials:HOME HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 TRANQUILITY PIKE
Mailing Address - Street 2:
Mailing Address - City:SEAMAN
Mailing Address - State:OH
Mailing Address - Zip Code:45679
Mailing Address - Country:US
Mailing Address - Phone:937-386-2863
Mailing Address - Fax:
Practice Address - Street 1:37 SOUTH NIXON AVE
Practice Address - Street 2:APT 1
Practice Address - City:PEEBLES
Practice Address - State:OH
Practice Address - Zip Code:45660
Practice Address - Country:US
Practice Address - Phone:937-587-9828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2686099Medicaid