Healthcare Provider Details

I. General information

NPI: 1255990305
Provider Name (Legal Business Name): CENTRIX HEALTH SYSTEMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2019
Last Update Date: 06/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

488 SAINT JAMES PL
SPRINGBORO OH
45066-9746
US

IV. Provider business mailing address

PO BOX 563
SPRINGBORO OH
45066-0563
US

V. Phone/Fax

Practice location:
  • Phone: 937-503-1962
  • Fax:
Mailing address:
  • Phone: 937-503-1962
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JAY ANTHONY VITALI
Title or Position: OWNER
Credential:
Phone: 937-503-1962