Healthcare Provider Details

I. General information

NPI: 1235707530
Provider Name (Legal Business Name): MEDINA NURSING SERVICES 'LLC'
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2021
Last Update Date: 06/14/2021
Certification Date: 06/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1172 WEST GALBRAITH RD SUITE 213
CINCINNATI OH
45231
US

IV. Provider business mailing address

1172 WEST GALBRAITH RD SUITE 213
CINCINNATI OH
45231
US

V. Phone/Fax

Practice location:
  • Phone: 513-601-1579
  • Fax: 513-521-1212
Mailing address:
  • Phone: 513-601-1579
  • Fax: 513-521-1212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: APRIL D WILSON
Title or Position: OWNER
Credential: RN,BSN
Phone: 513-601-1579