Healthcare Provider Details

I. General information

NPI: 1902178130
Provider Name (Legal Business Name): PERSONALIZED HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2012
Last Update Date: 04/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4663 EXECUTIVE DR STE# 1
COLUMBUS OH
43220
US

IV. Provider business mailing address

4663 EXECUTIVE DR STE# 1
COLUMBUS OH
43220-3627
US

V. Phone/Fax

Practice location:
  • Phone: 614-745-1176
  • Fax: 614-754-1288
Mailing address:
  • Phone: 614-754-1176
  • Fax: 614-754-1288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateOH

VIII. Authorized Official

Name: MS. KAREN S DAVID
Title or Position: PRESIDENT/CEO
Credential: R.N., B.S.C.,
Phone: 614-754-1176