Healthcare Provider Details

I. General information

NPI: 1659592269
Provider Name (Legal Business Name): MRS. MAGDA H MULFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 STATE ROUTE 7 N
CHESHIRE OH
45620-9002
US

IV. Provider business mailing address

8401 STATE ROUTE 7 N
CHESHIRE OH
45620-9002
US

V. Phone/Fax

Practice location:
  • Phone: 740-367-7803
  • Fax: 740-367-0917
Mailing address:
  • Phone: 740-367-7803
  • Fax: 740-367-0917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number2290284
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: