MEDICARE: INTERIM HEALTHCARE OF DAYTON, 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	251E00000X	Home Health Agency

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

General Provider Information

NPI Number	:	1255402780
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERIM HEALTHCARE OF DAYTON, INC.

Provider Business Mailing Address
First Line	:	5211 WAYNETOWNE CT STE C
Second Line	:
City	:	HUBER HEIGHTS
State	:	OH
Zip	:	45424-2124
Country	:	US
Telephone Number	:	937-291-5330
Fax Number	:	937-291-5336

Provider Business Practice Location Address
First Line	:	5211 WAYNETOWNE CT STE C
Second Line	:
City	:	HUBER HEIGHTS
State	:	OH
Zip	:	45424-2124
Country	:	US
Telephone Number	:	937-291-5330
Fax Number	:	937-291-5336

Authorized Official
Title or Position	:	CEO
Name	:	MR. THOMAS J DIMARCO
Credential	:
Telephone Number	:	614-436-9404

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	10/28/2020

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