Provider Demographics
NPI:1144660952
Name:OYSTER HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:OYSTER HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:OYSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-524-7200
Mailing Address - Street 1:P.O. BOX 74
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44901
Mailing Address - Country:US
Mailing Address - Phone:419-524-7200
Mailing Address - Fax:419-524-7203
Practice Address - Street 1:401 ASHLAND RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44905
Practice Address - Country:US
Practice Address - Phone:419-524-7200
Practice Address - Fax:419-524-7203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-26
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3595460Medicaid