Healthcare Provider Details

I. General information

NPI: 1548254683
Provider Name (Legal Business Name): CARROLL COUNTY VISITING NURSE ASSOC AND HOME HEALTH AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2005
Last Update Date: 01/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1029 COUNTRYSIDE DR NW
CARROLLTON OH
44615-9495
US

IV. Provider business mailing address

PO BOX 610
CARROLLTON OH
44615-9495
US

V. Phone/Fax

Practice location:
  • Phone: 330-627-7625
  • Fax: 330-627-8005
Mailing address:
  • Phone: 330-627-7625
  • Fax: 330-627-8005

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: MS. CHRISTAL ELAINE DEGARMO
Title or Position: ADMINISTRATOR
Credential:
Phone: 330-627-7625