Healthcare Provider Details

I. General information

NPI: 1841977816
Provider Name (Legal Business Name): SAMKEN HEALTH CO.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2023
Last Update Date: 07/21/2023
Certification Date: 07/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 KING AVE
MARION OH
43302-5323
US

IV. Provider business mailing address

707 KING AVE
MARION OH
43302-5323
US

V. Phone/Fax

Practice location:
  • Phone: 614-973-9373
  • Fax:
Mailing address:
  • Phone: 614-973-9373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3140N1450X
TaxonomyPediatric Skilled Nursing Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License Number
License Number State

VIII. Authorized Official

Name: MR. DONTAE NOEL
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 614-973-9373