Provider Demographics
NPI:1487758744
Name:AMSERV HEALTHCARE OF OHIO, INC
Entity type:Organization
Organization Name:AMSERV HEALTHCARE OF OHIO, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:STERNBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-423-6689
Mailing Address - Street 1:115 BROADHOLLOW RD
Mailing Address - Street 2:SUITE 275
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4992
Mailing Address - Country:US
Mailing Address - Phone:631-423-6689
Mailing Address - Fax:631-427-5466
Practice Address - Street 1:2003 W 4TH ST STE 116
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OH
Practice Address - Zip Code:44906-1865
Practice Address - Country:US
Practice Address - Phone:419-756-9449
Practice Address - Fax:419-756-4550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0972603Medicaid
OH367481Medicare ID - Type Unspecified