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General NPI Number Information
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NPI Number | 1295755189
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Entity Type | Organization
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Legal Business Name | UNITED CHURCH HOMES MANAGEMENT
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 170 E CENTER ST
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City | MARION
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State | OH
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Zip | 43302-1806
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Country | US
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Telephone | 937-293-1313
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Fax |
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Provider Business Mailing Address
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Address Line | 1313 W DOROTHY LN
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City | DAYTON
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State | OH
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Zip | 45409-1309
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Country | US
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Telephone | 937-293-1313
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BRIAN ALLEN
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Credential |
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Telephone | 740-382-4885
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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 | 51-022729
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License Number State | OH
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