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NPI Code Detail

MEDICARE: SIGNATURE HEALTH SERVICES, LLC

MEDICARE: SIGNATURE HEALTH SERVICES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency368015OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386634608
Entity Type Code : Organization
Provider Name (Legal Business Name) : SIGNATURE HEALTH SERVICES, LLC
Provider Business Mailing Address
First Line : 540 OFFICENTER PL
Second Line : SUITE 295
City : GAHANNA
State : OH
Zip : 43230-5317
Country : US
Telephone Number : 614-501-1879
Fax Number : 614-501-2934
Provider Business Practice Location Address
First Line : 540 OFFICENTER PL
Second Line : SUITE 295
City : GAHANNA
State : OH
Zip : 43230-5317
Country : US
Telephone Number : 614-501-1879
Fax Number : 614-501-2934
Authorized Official
Title or Position : COO
Name : JACK GOLDSBERRY
Credential :
Telephone Number : 330-666-3810
Provider Enumeration Date : 10/27/2005
Last Update Date : 08/13/2010

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Directions to “SIGNATURE HEALTH SERVICES, LLC ” Practice Location

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