Healthcare Provider Details

I. General information

NPI: 1114070711
Provider Name (Legal Business Name): VRABLE IV INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 E MIDLOTHIAN BLVD
YOUNGSTOWN OH
44502-2507
US

IV. Provider business mailing address

3248 HENDERSON RD
COLUMBUS OH
43220-7337
US

V. Phone/Fax

Practice location:
  • Phone: 330-788-3038
  • Fax: 330-788-1806
Mailing address:
  • Phone: 614-545-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number4293
License Number StateOH

VIII. Authorized Official

Name: MR. JAMES P. MERRILL
Title or Position: CFO
Credential:
Phone: 614-545-5500