Provider Demographics
NPI:1811998818
Name:AMERICAN FEDERATION OF STATE COUNTY& MUNICIPAL EMPLOYEES
Entity type:Organization
Organization Name:AMERICAN FEDERATION OF STATE COUNTY& MUNICIPAL EMPLOYEES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HOME HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHETSEL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:740-775-1114
Mailing Address - Street 1:150 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-2525
Mailing Address - Country:US
Mailing Address - Phone:740-775-1114
Mailing Address - Fax:740-772-2597
Practice Address - Street 1:150 E 2ND ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601
Practice Address - Country:US
Practice Address - Phone:740-775-1114
Practice Address - Fax:740-772-2597
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0050304Medicaid
OH0050304Medicaid