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General NPI Number Information
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NPI Number | 1144049842
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Entity Type | Organization
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Legal Business Name | PATRIOT HOMECARE NORTH, LLC
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Dates
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Enumeration Date | 10/09/2024
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 3515 MASSILLON RD STE 250
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City | UNIONTOWN
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State | OH
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Zip | 44685-7854
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Country | US
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Telephone | 330-735-6015
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Fax | 330-734-6017
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Provider Business Mailing Address
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Address Line | 986 TIBBETTS WICK RD
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City | GIRARD
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State | OH
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Zip | 44420-1138
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Country | US
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Telephone | 330-883-6532
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | SEAN DAVIS
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Credential |
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Telephone | 330-883-6532
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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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