Healthcare Provider Details
I. General information
NPI: 1538669098
Provider Name (Legal Business Name): NP SERVICES OF OH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/20/2018
Last Update Date: 02/02/2021
Certification Date: 02/02/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8230 MONTGOMERY RD STE 203
CINCINNATI OH
45236-2292
US
IV. Provider business mailing address
PO BOX 51266
LAFAYETTE LA
70505-1266
US
V. Phone/Fax
- Phone: 866-460-3567
- Fax: 855-632-8329
- Phone: 337-233-1307
- Fax: 337-233-5764
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
NICHOLAS
GACHASSIN
III
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 337-233-1307