Healthcare Provider Details

I. General information

NPI: 1467280750
Provider Name (Legal Business Name): THELMA DENISE TOOLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2024
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 721
GNADENHUTTEN OH
44629-0721
US

IV. Provider business mailing address

PO BOX 721
GNADENHUTTEN OH
44629-0721
US

V. Phone/Fax

Practice location:
  • Phone: 330-663-9702
  • Fax:
Mailing address:
  • Phone: 330-407-0941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberRL554583
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberRL554583
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: