Healthcare Provider Details

I. General information

NPI: 1487068581
Provider Name (Legal Business Name): SOURCEPOINT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 09/30/2020
Certification Date: 09/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 CHESHIRE RD
DELAWARE OH
43015-6038
US

IV. Provider business mailing address

800 CHESHIRE RD
DELAWARE OH
43015-6038
US

V. Phone/Fax

Practice location:
  • Phone: 740-363-6677
  • Fax: 740-363-7588
Mailing address:
  • Phone: 740-363-6677
  • Fax: 740-363-7588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY MARIE CLEWELL
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 740-203-2353