=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861187809
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VISITING NURSE HOSPICE AND HEALTH CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/06/2023
-----------------------------------------------------
Last Update Date | 04/06/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5340 HARROUN RD
-----------------------------------------------------
City | SYLVANIA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43560-2114
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-824-8840
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5340 HARROUN RD
-----------------------------------------------------
City | SYLVANIA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43560-2114
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-824-8840
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MARTIN DAVID ALLEN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 419-252-5734
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251G00000X
-----------------------------------------------------
Taxonomy Name | Community Based Hospice Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------