Healthcare Provider Details

I. General information

NPI: 1831079938
Provider Name (Legal Business Name): PET PEEVEZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2619 WILLOWGATE RD
GROVE CITY OH
43123-1591
US

IV. Provider business mailing address

2619 WILLOWGATE RD
GROVE CITY OH
43123-1591
US

V. Phone/Fax

Practice location:
  • Phone: 614-516-8951
  • Fax: 614-516-8951
Mailing address:
  • Phone: 614-516-8951
  • Fax: 614-516-8951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MS. SUMMER JOHNSON
Title or Position: CEO
Credential:
Phone: 614-516-8951