Healthcare Provider Details

I. General information

NPI: 1093948127
Provider Name (Legal Business Name): MILLER HEALTH CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2009
Last Update Date: 08/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5661 HARSHMANVILLE RD
HUBER HEIGHTS OH
45424-5353
US

IV. Provider business mailing address

5661 HARSHMANVILLE ROAD
HUBER HEIGHTS OH
45424
US

V. Phone/Fax

Practice location:
  • Phone: 937-242-6265
  • Fax:
Mailing address:
  • Phone: 937-242-6265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number135359
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code3140N1450X
TaxonomyPediatric Skilled Nursing Facility
License Number135359
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number135359
License Number StateOH

VIII. Authorized Official

Name: MS. SHERANDA LYNNETTE MILLER
Title or Position: LICENSED PRACTICAL NURSE
Credential: LPN
Phone: 937-242-6265