Healthcare Provider Details

I. General information

NPI: 1528291192
Provider Name (Legal Business Name): INTERIM PLUS AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2009
Last Update Date: 08/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 MORSE RD STE 307
COLUMBUS OH
43229-6327
US

IV. Provider business mailing address

1150 MORSE RD STE 307
COLUMBUS OH
43229-6327
US

V. Phone/Fax

Practice location:
  • Phone: 614-270-0448
  • Fax:
Mailing address:
  • Phone: 614-270-0448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. ERNEST M OPUNI
Title or Position: PRESIDENT
Credential:
Phone: 614-270-0448