MEDICARE: MAPLE HILL, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	42018117	OH
2	3336C0003X	Community/Retail Pharmacy	020839650	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3661130	OTHER	OH	NABP NUMBER

General Provider Information

NPI Number	:	1033117510
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAPLE HILL, INC.

Provider Business Mailing Address
First Line	:	4584 COLUMBUS RD
Second Line	:
City	:	CENTERBURG
State	:	OH
Zip	:	43011-9401
Country	:	US
Telephone Number	:	740-625-7626
Fax Number	:	740-625-7640

Provider Business Practice Location Address
First Line	:	4584 COLUMBUS RD
Second Line	:
City	:	CENTERBURG
State	:	OH
Zip	:	43011-9401
Country	:	US
Telephone Number	:	740-625-7626
Fax Number	:	740-625-7640

Authorized Official
Title or Position	:	OWNER
Name	:	DARLENE CHILDERS
Credential	:	RPH
Telephone Number	:	740-625-7626

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	02/04/2021

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Directions to “MAPLE HILL, INC. ” Practice Location

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