Provider Demographics
NPI:1780343889
Name:HOME HEALTH MDS
Entity type:Organization
Organization Name:HOME HEALTH MDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:UGOALA
Authorized Official - Middle Name:C
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-505-6309
Mailing Address - Street 1:PO BOX 316
Mailing Address - Street 2:
Mailing Address - City:KINGS MILLS
Mailing Address - State:OH
Mailing Address - Zip Code:45034-0316
Mailing Address - Country:US
Mailing Address - Phone:513-667-9251
Mailing Address - Fax:513-486-1868
Practice Address - Street 1:464 ATTLEBORO CT
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-2213
Practice Address - Country:US
Practice Address - Phone:513-667-9251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-16
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty