MEDICARE: SSTH, 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
1	251E00000X	Home Health Agency		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

General Provider Information

NPI Number	:	1306899331
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SSTH, LLC

Provider Business Mailing Address
First Line	:	739 S JAMES RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43227-1098
Country	:	US
Telephone Number	:	614-884-0793
Fax Number	:	614-884-0795

Provider Business Practice Location Address
First Line	:	739 S JAMES RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43227-1098
Country	:	US
Telephone Number	:	614-884-0793
Fax Number	:	614-884-0795

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. TIMOTHY W HANNERS
Credential	:
Telephone Number	:	614-884-0793

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	08/22/2020

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Directions to “SSTH, LLC ” Practice Location

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