Healthcare Provider Details

I. General information

NPI: 1154572576
Provider Name (Legal Business Name): RUSSENDIPITY LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2008
Last Update Date: 10/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 W HENDERSON RD SUITE 330
COLUMBUS OH
43220-2453
US

IV. Provider business mailing address

2000 W HENDERSON RD SUITE 330
COLUMBUS OH
43220-2453
US

V. Phone/Fax

Practice location:
  • Phone: 614-442-1000
  • Fax: 614-442-1002
Mailing address:
  • Phone: 614-442-1000
  • Fax: 614-442-1002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFREY DALE RUSSELL
Title or Position: OWNER
Credential:
Phone: 614-442-1000