Healthcare Provider Details

I. General information

NPI: 1760583272
Provider Name (Legal Business Name): ESSEX HEALTHCARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

924 CHARLIES WAY
MONTPELIER OH
43543-1904
US

IV. Provider business mailing address

1 EASTON OVAL SUITE 300
COLUMBUS OH
43219-6061
US

V. Phone/Fax

Practice location:
  • Phone: 419-485-8307
  • Fax:
Mailing address:
  • Phone: 614-416-2662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1513N
License Number StateOH

VIII. Authorized Official

Name: KEITH JAMES YODER
Title or Position: CFO
Credential:
Phone: 614-416-2662