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NPI Code Detail

MEDICARE: BOSCHULTE'S PRIDE II LLC

MEDICARE: BOSCHULTE'S PRIDE II 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
1251E00000XHome Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912158304
Entity Type Code : Organization
Provider Name (Legal Business Name) : BOSCHULTE'S PRIDE II LLC
Provider Business Mailing Address
First Line : 2242 S HAMILTON RD STE 201
Second Line :
City : COLUMBUS
State : OH
Zip : 43232-4300
Country : US
Telephone Number : 614-751-6308
Fax Number : 614-751-6342
Provider Business Practice Location Address
First Line : 2242 S HAMILTON RD STE 201
Second Line :
City : COLUMBUS
State : OH
Zip : 43232-4300
Country : US
Telephone Number : 614-751-6308
Fax Number : 614-751-6342
Authorized Official
Title or Position : ADMINISTRATOR/DIRECTOR OF NURSING
Name : MR. MARY L BOSCHULTE
Credential :
Telephone Number : 614-751-6308
Provider Enumeration Date : 10/03/2008
Last Update Date : 03/14/2017

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Directions to “BOSCHULTE'S PRIDE II LLC ” Practice Location

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