Healthcare Provider Details

I. General information

NPI: 1003197401
Provider Name (Legal Business Name): INFINITY HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2011
Last Update Date: 04/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 N. JACKSON STREET
SOUTH WEBSTER OH
45682-9058
US

IV. Provider business mailing address

PO BOX 422
SOUTH WEBSTER OH
45682-0422
US

V. Phone/Fax

Practice location:
  • Phone: 740-778-3000
  • Fax: 740-778-3999
Mailing address:
  • Phone: 740-778-3000
  • Fax: 740-778-3999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. TIFFANY MICHELLE SLAUGHTER
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 740-778-3000