Healthcare Provider Details
I. General information
NPI: 1467658831
Provider Name (Legal Business Name): TNT'S DYNAMITE HOME HEALTH CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1313 E BROAD ST
COLUMBUS OH
43205-3500
US
IV. Provider business mailing address
1313 E BROAD ST
COLUMBUS OH
43205-3500
US
V. Phone/Fax
- Phone: 614-257-1060
- Fax: 614-257-1062
- Phone: 614-257-1060
- Fax: 614-257-1062
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | 1690116 |
| License Number State | OH |
VIII. Authorized Official
Name: MS.
TINNA
HARRIS
Title or Position: CEO
Credential:
Phone: 614-257-1060