Ohio Medicaid Provider

LBN: Ohio Medicaid Provider
Ohio Medicaid Provider is an health care organization with primary practice located at 322 Albers Ave , Dayton OH 45427-1703. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Adult Care Home, which is considered as the primary health care specialty. Ohio Medicaid Provider can be contacted via phone (937) 479-1676, or through Ballard, Saundra Lee via phone (937) 479-1676.

Contact Information

Primary practice address
322 Albers Ave Dayton OH 45427-1703
Phone: (937) 479-1676
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ballard, Saundra Lee Licensed Practical Nurse (LPN)
Phone: (937) 479-1676

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Adult Care Home 311ZA0620X PN0830007 Ohio

Profile Details

NPI number 1659555407
LBN Legal business name Ohio Medicaid Provider
DBA Doing business as
Authorized official Ballard, Saundra Lee Licensed Practical Nurse (LPN)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 27th, 2007
Last updated Dec 27th, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659555407 NPPES
Ohio MEDICAID 2516950

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