Healthcare Provider Details

I. General information

NPI: 1235929373
Provider Name (Legal Business Name): TIMOTHY ALEXANDER BABIUCH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 ROCHELLE RD
TOLEDO OH
43615-4927
US

IV. Provider business mailing address

1272 KIRK ST
MAUMEE OH
43537-3248
US

V. Phone/Fax

Practice location:
  • Phone: 419-867-8244
  • Fax:
Mailing address:
  • Phone: 567-277-8243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: