Healthcare Provider Details
I. General information
NPI: 1033300462
Provider Name (Legal Business Name): NURSE MEDICAL HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/09/2007
Last Update Date: 09/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4770 INDIANOLA AVE SUITE 270
COLUMBUS OH
43214-1862
US
IV. Provider business mailing address
4770 INDIANOLA AVE SUITE 270
COLUMBUS OH
43214-1862
US
V. Phone/Fax
- Phone: 614-781-0244
- Fax: 614-781-0208
- Phone: 614-781-0244
- Fax: 614-781-0208
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JOHNNIE
LEE
BERRY
Title or Position: PRESIDENT CEO
Credential:
Phone: 614-781-0244