=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902804206
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEALTH CARE SERVICES, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/11/2005
-----------------------------------------------------
Last Update Date | 05/23/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7642 PRODUCTION DR
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45237-3209
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-761-8100
-----------------------------------------------------
Fax | 513-948-6616
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7642 PRODUCTION DR
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45237-3209
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-761-8100
-----------------------------------------------------
Fax | 513-948-6616
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | GM
-----------------------------------------------------
Name | MR. LEN T ELDRIDGE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 513-761-8100
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 332BX2000X
-----------------------------------------------------
Taxonomy Name | Oxygen Equipment & Supplies (DME)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------