Healthcare Provider Details

I. General information

NPI: 1881942613
Provider Name (Legal Business Name): SYLVIA M GRUBBS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2012
Last Update Date: 03/27/2024
Certification Date: 03/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6918 GALVIN AVE
DAYTON OH
45417-7702
US

IV. Provider business mailing address

6918 GALVIN AVE
DAYTON OH
45417-7702
US

V. Phone/Fax

Practice location:
  • Phone: 937-760-6096
  • Fax: 937-235-6754
Mailing address:
  • Phone: 937-760-6096
  • Fax: 937-235-6754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number228096
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: