Healthcare Provider Details

I. General information

NPI: 1356049019
Provider Name (Legal Business Name): BUCKEYE BED BUG DETECTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2023
Last Update Date: 05/02/2023
Certification Date: 05/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 COUNTY LINE RD NE
RUSHVILLE OH
43150-9720
US

IV. Provider business mailing address

2510 COUNTY LINE RD NE
RUSHVILLE OH
43150-9720
US

V. Phone/Fax

Practice location:
  • Phone: 614-949-9058
  • Fax:
Mailing address:
  • Phone: 614-949-9058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER HAWKS
Title or Position: OWNER
Credential:
Phone: 614-949-9058