Provider Demographics
NPI:1134395700
Name:EAST OHIO HOMECARE
Entity type:Organization
Organization Name:EAST OHIO HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER APPLICATIONS
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:EBBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-234-8663
Mailing Address - Street 1:90 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MARTINS FERRY
Mailing Address - State:OH
Mailing Address - Zip Code:43935-1648
Mailing Address - Country:US
Mailing Address - Phone:740-633-1100
Mailing Address - Fax:
Practice Address - Street 1:90 N 4TH ST
Practice Address - Street 2:
Practice Address - City:MARTINS FERRY
Practice Address - State:OH
Practice Address - Zip Code:43935-1648
Practice Address - Country:US
Practice Address - Phone:740-633-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EAST OHIO REGIONAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1114251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0892002Medicaid