Healthcare Provider Details

I. General information

NPI: 1376179556
Provider Name (Legal Business Name): OHIO HOME RENOVATIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2020
Last Update Date: 03/19/2020
Certification Date: 03/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9220 SHAWNEE TRL
POWELL OH
43065-5012
US

IV. Provider business mailing address

PO BOX 3231
DUBLIN OH
43016-0105
US

V. Phone/Fax

Practice location:
  • Phone: 614-554-3951
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: RICHARD POMANTE
Title or Position: OWNER
Credential:
Phone: 614-554-3951