Healthcare Provider Details
I. General information
NPI: 1629863642
Provider Name (Legal Business Name): INTERIM HEALTHCARE SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/10/2025
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4130 GALLIA ST
NEW BOSTON OH
45662-5511
US
IV. Provider business mailing address
4130 GALLIA ST
NEW BOSTON OH
45662-5511
US
V. Phone/Fax
- Phone: 740-354-5550
- Fax: 740-354-5670
- Phone: 740-354-5550
- Fax: 740-354-5670
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KELLI
CONKLIN
Title or Position: PRESIDENT
Credential:
Phone: 740-354-5550