Provider Demographics
NPI:1396773909
Name:EPILOGUE INC.
Entity type:Organization
Organization Name:EPILOGUE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:BUESCH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:440-582-5555
Mailing Address - Street 1:PO BOX 33154
Mailing Address - Street 2:12333 RIDGE ROAD SUITE 5
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-0154
Mailing Address - Country:US
Mailing Address - Phone:440-582-5555
Mailing Address - Fax:
Practice Address - Street 1:12333 RIDGE RD
Practice Address - Street 2:SUITE 5
Practice Address - City:NORTH ROYALTON
Practice Address - State:OH
Practice Address - Zip Code:44133-3700
Practice Address - Country:US
Practice Address - Phone:440-582-5555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0904267Medicaid
OH31968276OtherOHIO DEPARTMENT ON AGING
OH367496Medicare PIN