=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407516883
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEART TO HEART HEALTH SERVICES OF OHIO LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/27/2021
-----------------------------------------------------
Last Update Date | 12/27/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5500 MARKET ST STE 120
-----------------------------------------------------
City | YOUNGSTOWN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44512-2625
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-953-2700
-----------------------------------------------------
Fax | 330-953-2705
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 195 HAMILTON AVE
-----------------------------------------------------
City | CAMPBELL
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44405-1866
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-382-0570
-----------------------------------------------------
Fax | 330-953-2705
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | THERESSA MILHOUSE
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 330-953-2700
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 291U00000X
-----------------------------------------------------
Taxonomy Name | Clinical Medical Laboratory
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------