MEDICARE: CARROLL COUNTY VISITING NURSE ASSOC AND HOME HEALTH AGENCY

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	:	1548254683
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARROLL COUNTY VISITING NURSE ASSOC AND HOME HEALTH AGENCY

Provider Business Mailing Address
First Line	:	PO BOX 610
Second Line	:
City	:	CARROLLTON
State	:	OH
Zip	:	44615-9495
Country	:	US
Telephone Number	:	330-627-7625
Fax Number	:	330-627-8005

Provider Business Practice Location Address
First Line	:	1029 COUNTRYSIDE DR NW
Second Line	:
City	:	CARROLLTON
State	:	OH
Zip	:	44615-9495
Country	:	US
Telephone Number	:	330-627-7625
Fax Number	:	330-627-8005

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. CHRISTAL ELAINE DEGARMO
Credential	:
Telephone Number	:	330-627-7625

Provider Enumeration Date	:	09/06/2005
Last Update Date	:	01/22/2019

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