Healthcare Provider Details

I. General information

NPI: 1750016705
Provider Name (Legal Business Name): MEVYIA HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2022
Last Update Date: 07/22/2022
Certification Date: 07/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7577 CENTRAL PARKE BLVD STE 302
MASON OH
45040-6807
US

IV. Provider business mailing address

7577 CENTRAL PARKE BLVD STE 302
MASON OH
45040-6807
US

V. Phone/Fax

Practice location:
  • Phone: 513-223-9262
  • Fax: 513-701-9091
Mailing address:
  • Phone: 513-223-9262
  • Fax: 513-701-9091

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: SAMUEL DWOMOH
Title or Position: OWNER
Credential:
Phone: 513-223-9262