Healthcare Provider Details

I. General information

NPI: 1750166104
Provider Name (Legal Business Name): MYERS PCAH CARES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2023
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 W MARKET ST STE 180
LIMA OH
45801-4820
US

IV. Provider business mailing address

220 W MARKET ST STE 180
LIMA OH
45801-4820
US

V. Phone/Fax

Practice location:
  • Phone: 419-603-4663
  • Fax:
Mailing address:
  • Phone: 419-603-4663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ANA CAROLINA MYERS
Title or Position: OWNER
Credential:
Phone: 561-465-6007