Healthcare Provider Details

I. General information

NPI: 1801671870
Provider Name (Legal Business Name): HEALTHDRIVE MEDICAL SERVICES MIDWEST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2023
Last Update Date: 03/11/2024
Certification Date: 03/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 METRO PL S STE 600
DUBLIN OH
43017-3394
US

IV. Provider business mailing address

100 CROSSING BLVD STE 300
FRAMINGHAM MA
01702-5555
US

V. Phone/Fax

Practice location:
  • Phone: 888-964-6681
  • Fax: 888-662-0859
Mailing address:
  • Phone: 617-964-6681
  • Fax: 339-686-2561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DANIEL BAKER
Title or Position: PRESIDENT
Credential:
Phone: 857-255-0486