Provider Demographics
NPI:1750771689
Name:HOMESITE HOME HEALTH CARE - CENTRAL OHIO
Entity type:Organization
Organization Name:HOMESITE HOME HEALTH CARE - CENTRAL OHIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:D
Authorized Official - Last Name:PENCIL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:937-845-1486
Mailing Address - Street 1:266 BRUBAKER DR
Mailing Address - Street 2:
Mailing Address - City:NEW CARLISLE
Mailing Address - State:OH
Mailing Address - Zip Code:45344-1414
Mailing Address - Country:US
Mailing Address - Phone:937-845-1486
Mailing Address - Fax:937-845-1520
Practice Address - Street 1:266 BRUBAKER DR
Practice Address - Street 2:
Practice Address - City:NEW CARLISLE
Practice Address - State:OH
Practice Address - Zip Code:45344-1414
Practice Address - Country:US
Practice Address - Phone:937-845-1486
Practice Address - Fax:937-845-1520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-30
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care