Provider Demographics
NPI:1174952196
Name:VETERANS HOME MAINTENANCE LLC
Entity type:Organization
Organization Name:VETERANS HOME MAINTENANCE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GAYLAND
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, PE
Authorized Official - Phone:440-227-8051
Mailing Address - Street 1:4939 N ZETZER RD
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:OH
Mailing Address - Zip Code:43449-9744
Mailing Address - Country:US
Mailing Address - Phone:419-898-1620
Mailing Address - Fax:
Practice Address - Street 1:4939 N ZETZER RD
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:OH
Practice Address - Zip Code:43449-9744
Practice Address - Country:US
Practice Address - Phone:419-898-1620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-12
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization