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General NPI Number Information
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NPI Number | 1043936115
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Entity Type | Organization
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Legal Business Name | SUSTAINERS HEALTHCARE LLC
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Dates
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Enumeration Date | 10/19/2022
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 6432 COLD MOUNTAIN DR
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City | WESTERVILLE
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State | OH
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Zip | 43081-0027
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Country | US
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Telephone | 614-500-9676
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Fax |
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Provider Business Mailing Address
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Address Line | 6432 COLD MOUNTAIN DR
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City | WESTERVILLE
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State | OH
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Zip | 43081-0027
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Country | US
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Telephone | 614-500-9676
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. BEZANKENG WANATU
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Credential | N/A
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Telephone | 614-500-9676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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