Provider Demographics
NPI:1245373125
Name:FURROW, TARI LEE (STNA HHA)
Entity type:Individual
Prefix:MRS
First Name:TARI
Middle Name:LEE
Last Name:FURROW
Suffix:
Gender:F
Credentials:STNA HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3074 SO ST RTE 560
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:OH
Mailing Address - Zip Code:43078-9610
Mailing Address - Country:US
Mailing Address - Phone:937-788-2425
Mailing Address - Fax:
Practice Address - Street 1:179 SUNRISE TERRACE
Practice Address - Street 2:
Practice Address - City:NEW CARLISLE
Practice Address - State:OH
Practice Address - Zip Code:45344-1430
Practice Address - Country:US
Practice Address - Phone:937-845-1885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
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
OH2397580Medicaid
OH400148650802OtherSTNA