Healthcare Provider Details

I. General information

NPI: 1154945210
Provider Name (Legal Business Name): AUXILIUM HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2020
Last Update Date: 07/17/2020
Certification Date: 07/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3360 E LIVINGSTON AVE STE 1B
COLUMBUS OH
43227-1961
US

IV. Provider business mailing address

3360 E LIVINGSTON AVE STE 1B
COLUMBUS OH
43227-1961
US

V. Phone/Fax

Practice location:
  • Phone: 614-216-5161
  • Fax: 614-231-8108
Mailing address:
  • Phone: 614-216-5161
  • Fax:

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 Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. HALE HARMON
Title or Position: PRESIDENT
Credential:
Phone: 614-216-5161