Healthcare Provider Details

I. General information

NPI: 1134985435
Provider Name (Legal Business Name): PROMINENT HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2024
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8136 NARROW LEAF DR
BLACKLICK OH
43004-7516
US

IV. Provider business mailing address

8136 NARROW LEAF DR
BLACKLICK OH
43004-7516
US

V. Phone/Fax

Practice location:
  • Phone: 614-732-3436
  • Fax:
Mailing address:
  • Phone: 614-732-3436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL

VIII. Authorized Official

Name: ERNEST FON
Title or Position: OWNER
Credential:
Phone: 614-732-3436