Healthcare Provider Details

I. General information

NPI: 1073909602
Provider Name (Legal Business Name): ENGINUIT DESIGN LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2015
Last Update Date: 11/10/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4114 MAPLEVIEW DR
BEAVERCREEK OH
45432-1920
US

IV. Provider business mailing address

4114 MAPLEVIEW DR
BEAVERCREEK OH
45432-1920
US

V. Phone/Fax

Practice location:
  • Phone: 937-490-9200
  • Fax: 937-490-9200
Mailing address:
  • Phone: 937-490-9200
  • Fax: 937-490-9200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateOH

VIII. Authorized Official

Name: MR. JOSH C ISON
Title or Position: DIRECTOR
Credential:
Phone: 937-490-9200