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General NPI Number Information
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NPI Number | 1003914755
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Entity Type | Organization
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Legal Business Name | DEARTH HOMES, INC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 25326 SNIVELY RD
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City | DANVILLE
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State | OH
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Zip | 43014-9761
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Country | US
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Telephone | 740-599-6357
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Fax | 740-599-5692
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Provider Business Mailing Address
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Address Line | 25326 SNIVELY RD
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City | DANVILLE
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State | OH
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Zip | 43014-9761
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Country | US
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Telephone | 740-599-6357
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Fax | 740-599-5692
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Authorized Official
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Title or Position | VICE PRESIDENT OF FINANCE
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Name | TAMARA K SHEPHERD
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Credential |
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Telephone | 614-847-1070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 0812
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License Number State | OH
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