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NPI Code Detail

MEDICARE: PROVIDENTIAL HEALTHCARE LLC

MEDICARE: PROVIDENTIAL HEALTHCARE LLC
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
1343900000XNon-emergency Medical Transport (VAN)
2374U00000XHome Health Aide
3376J00000XHomemaker

General Provider Information

NPI Number : 1295691343
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROVIDENTIAL HEALTHCARE LLC
Provider Business Mailing Address
First Line : 2840 MACK RD
Second Line :
City : FAIRFIELD
State : OH
Zip : 45014-5130
Country : US
Telephone Number : 513-365-0882
Fax Number :
Provider Business Practice Location Address
First Line : 2840 MACK RD
Second Line :
City : FAIRFIELD
State : OH
Zip : 45014-5130
Country : US
Telephone Number : 513-365-0882
Fax Number :
Authorized Official
Title or Position : CEO/OWNER
Name : EUGENIA MARY TWUMWAA
Credential : RN
Telephone Number : 513-365-0882
Provider Enumeration Date : 01/02/2026
Last Update Date : 01/02/2026

Similar Medicare Providers

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Practice Location Address:
2840 MACK RD
FAIRFIELD, OH
45014-5130
Practice Phone: 513-365-0882
Practice Fax:
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1801861372 — DR. JOEANNE GUTZWILLER PH.D.
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FAIRFIELD, OH
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1316912421 — DR. THOMAS E. SULLIVAN PH.D.
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FAIRFIELD, OH
45014-5130
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45014-5130
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Directions to “PROVIDENTIAL HEALTHCARE LLC ” Practice Location

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