Healthcare Provider Details

I. General information

NPI: 1295026995
Provider Name (Legal Business Name): HOSPICE OF NORTH CENTRAL OHIO, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2011
Last Update Date: 10/26/2021
Certification Date: 10/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 DAUCH DR
ASHLAND OH
44805-8845
US

IV. Provider business mailing address

1021 DAUCH DR
ASHLAND OH
44805-8845
US

V. Phone/Fax

Practice location:
  • Phone: 419-281-7107
  • Fax: 419-289-4880
Mailing address:
  • Phone: 419-281-7107
  • Fax: 419-289-4880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberNP28271
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.044505
License Number StateOH

VIII. Authorized Official

Name: KIMBERLY A GIFFIN
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 419-281-7107