Provider Demographics
NPI:1932828654
Name:DUBLIN DIRECT CARE LLC
Entity Type:Organization
Organization Name:DUBLIN DIRECT CARE LLC
Other - Org Name:DUBLIN DIRECT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENEDICT
Authorized Official - Middle Name:T
Authorized Official - Last Name:AWO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:614-389-5452
Mailing Address - Street 1:5040 BRADENTON AVE STE A
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-3524
Mailing Address - Country:US
Mailing Address - Phone:614-389-5452
Mailing Address - Fax:
Practice Address - Street 1:5040 BRADENTON AVE STE A
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-3524
Practice Address - Country:US
Practice Address - Phone:614-389-5452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-25
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty