Healthcare Provider Details

I. General information

NPI: 1235947862
Provider Name (Legal Business Name): TAYLOR A PURDY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2024
Last Update Date: 12/30/2024
Certification Date: 12/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8391 COLUMBUS RD
MOUNT VERNON OH
43050-9366
US

IV. Provider business mailing address

8391 COLUMBUS RD
MOUNT VERNON OH
43050-9366
US

V. Phone/Fax

Practice location:
  • Phone: 740-501-6621
  • Fax:
Mailing address:
  • Phone: 740-501-6621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: