Grimm, Dwight
Grimm, Dwight is an sole proprietor health care provider with primary practice located at 912 Waynoka Dr , Lake Waynoka OH 45171-9760. He recently has only one registered license in Nursing Service Related Providers / Homemaker, which is considered as his primary health care specialty. Grimm, Dwight can be contacted via phone (937) 446-4149.Contact Information
Primary practice address
912 Waynoka Dr
Lake Waynoka OH 45171-9760
Phone: (937) 446-4149
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Related Providers / Homemaker | 376J00000X |
Profile Details
| NPI number | 1467069658 |
|---|---|
| LBN Legal business name | Grimm, Dwight |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 30th, 2020 |
| Last updated | Sep 30th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467069658 | NPPES |
| Ohio | MEDICAID | 2971048 | |
| Ohio | MEDICAID | 0800557 |
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