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General NPI Number Information
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NPI Number | 1750151148
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Entity Type | Organization
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Legal Business Name | SHAWNTIS HOMECARE LLC
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Dates
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Enumeration Date | 01/05/2024
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 5816 CHATFORD DR APT B
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City | COLUMBUS
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State | OH
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Zip | 43232-3181
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Country | US
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Telephone | 240-791-1070
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Fax |
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Provider Business Mailing Address
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Address Line | 5816 CHATFORD DR APT B
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City | COLUMBUS
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State | OH
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Zip | 43232-3181
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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 | ADMINISTRATOR
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Name | MRS. OLYVIA TANKOH
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Credential |
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Telephone | 380-276-7640
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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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