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General NPI Number Information
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NPI Number | 1114622081
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Entity Type | Organization
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Legal Business Name | BUCKEYES SERVICE LLC
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Dates
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Enumeration Date | 03/31/2023
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 6100 CHANNINGWAY BLVD # CC-310G
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City | COLUMBUS
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State | OH
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Zip | 43232-2910
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Country | US
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Telephone | 614-591-9797
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Fax |
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Provider Business Mailing Address
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Address Line | 5452 ROHDEN DR
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City | CANAL WINCHESTER
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State | OH
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Zip | 43110-9121
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Country | US
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Telephone | 703-663-0020
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NOUROULDINE DIALLO
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Credential |
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Telephone | 703-663-0020
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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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