Healthcare Provider Details

I. General information

NPI: 1508274150
Provider Name (Legal Business Name): RANDALL HYMER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2014
Last Update Date: 07/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5845 LIBERTY FAIRFIELD RD
LIBERTY TWP OH
45011-6215
US

IV. Provider business mailing address

5845 LIBERTY FAIRFIELD RD
LIBERTY TWP OH
45011-6215
US

V. Phone/Fax

Practice location:
  • Phone: 513-737-5327
  • Fax:
Mailing address:
  • Phone: 513-737-5327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: