Provider Demographics
NPI:1184781106
Name:HEALTHCARE SPECIALIST
Entity type:Organization
Organization Name:HEALTHCARE SPECIALIST
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP HUMAN RESOURCES
Authorized Official - Prefix:MS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:567-661-0664
Mailing Address - Street 1:701 JEFFERSON AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1955
Mailing Address - Country:US
Mailing Address - Phone:567-661-0614
Mailing Address - Fax:419-724-2822
Practice Address - Street 1:701 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43624-1955
Practice Address - Country:US
Practice Address - Phone:567-661-0614
Practice Address - Fax:419-724-2822
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOB1USA / RUMPF CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-02
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0482937Medicaid