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General NPI Number Information
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NPI Number | 1639414063
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Entity Type | Organization
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Legal Business Name | FIDELITY HEALTH CARE INC
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Dates
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Enumeration Date | 12/12/2012
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Last Update Date | 08/19/2013
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Provider Practice Location Address
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Address Line | 8385 N MAIN ST
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City | DAYTON
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State | OH
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Zip | 45415-1602
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Country | US
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Telephone | 937-898-1566
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Fax |
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Provider Business Mailing Address
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Address Line | 3832 KETTERING BLVD
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City | MORAINE
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State | OH
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Zip | 45439-2017
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & CFO
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Name | PAULA THOMPSON
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Credential |
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Telephone | 937-208-6461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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