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General NPI Number Information
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NPI Number | 1205924685
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Entity Type | Organization
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Legal Business Name | HOLZER SENIOR CARE CENTER
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 10/11/2017
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Provider Practice Location Address
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Address Line | 380 COLONIAL DR
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City | BIDWELL
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State | OH
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Zip | 45614-9215
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Country | US
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Telephone | 740-446-5001
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Fax | 740-446-5101
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Provider Business Mailing Address
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Address Line | 380 COLONIAL DR
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City | BIDWELL
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State | OH
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Zip | 45614-9215
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Country | US
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Telephone | 740-446-5001
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Fax | 740-446-5101
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Authorized Official
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Title or Position | VICE PRESIDENT FINANCE
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Name | WILLIAM CRABTREE
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Credential |
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Telephone | 740-288-0192
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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 | N/A IN OHIO
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License Number State |
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