Healthcare Provider Details

I. General information

NPI: 1407773500
Provider Name (Legal Business Name): JJHSUPPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5480 ROTHERMUND DR
CANAL WINCHESTER OH
43110-7990
US

IV. Provider business mailing address

5480 ROTHERMUND DR
CANAL WINCHESTER OH
43110-7990
US

V. Phone/Fax

Practice location:
  • Phone: 614-787-4916
  • Fax:
Mailing address:
  • Phone: 614-787-4916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH HAIR
Title or Position: ADMIN.
Credential:
Phone: 614-787-4916