Healthcare Provider Details

I. General information

NPI: 1588445118
Provider Name (Legal Business Name): PUCKETT'S HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2023
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3915 HAMILTON MIDDLETOWN RD
HAMILTON OH
45011-2571
US

IV. Provider business mailing address

3915 HAMILTON MIDDLETOWN RD
HAMILTON OH
45011-2571
US

V. Phone/Fax

Practice location:
  • Phone: 513-301-8598
  • Fax:
Mailing address:
  • Phone: 513-301-8598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: PAUL PUCKETT
Title or Position: CEO
Credential:
Phone: 513-301-8598