Provider Demographics
NPI:1548254683
Name:CARROLL COUNTY VISITING NURSE ASSOC AND HOME HEALTH AGENCY
Entity type:Organization
Organization Name:CARROLL COUNTY VISITING NURSE ASSOC AND HOME HEALTH AGENCY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTAL
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:DEGARMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-627-7625
Mailing Address - Street 1:PO BOX 610
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:OH
Mailing Address - Zip Code:44615-9495
Mailing Address - Country:US
Mailing Address - Phone:330-627-7625
Mailing Address - Fax:330-627-8005
Practice Address - Street 1:1029 COUNTRYSIDE DR NW
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:OH
Practice Address - Zip Code:44615-9495
Practice Address - Country:US
Practice Address - Phone:330-627-7625
Practice Address - Fax:330-627-8005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-06
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0339628Medicaid
OH367141Medicare Oscar/Certification