Provider Demographics
NPI:1245454875
Name:DELNA HEALTH ENTERPRISE
Entity type:Organization
Organization Name:DELNA HEALTH ENTERPRISE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOTISTPROSTHETIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:NALLS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:440-322-5416
Mailing Address - Street 1:436 E RIVER ST
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-5200
Mailing Address - Country:US
Mailing Address - Phone:440-322-5416
Mailing Address - Fax:
Practice Address - Street 1:436 E RIVER ST
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-5200
Practice Address - Country:US
Practice Address - Phone:440-322-5416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLO0201332B00000X, 332BC3200X
OHLO021335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Not Answered335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2293209Medicaid
OH2293209Medicaid