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General NPI Number Information
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NPI Number | 1104259779
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Entity Type | Organization
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Legal Business Name | MIDWEST HEALTHCARE SERVICES
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Dates
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Enumeration Date | 08/18/2013
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Last Update Date | 08/18/2013
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Provider Practice Location Address
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Address Line | 5625 N HIGH ST SUITE 9C
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City | WORTHINGTON
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State | OH
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Zip | 43085-3964
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Country | US
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Telephone | 740-707-9796
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Fax |
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Provider Business Mailing Address
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Address Line | 5625 N HIGH ST SUITE 9C
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City | WORTHINGTON
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State | OH
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Zip | 43085-3964
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. BRIAN KASVOSVE
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Credential |
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Telephone | 740-707-9796
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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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