Provider Demographics
NPI:1750609863
Name:PRIORITY HOME CARE LLC
Entity type:Organization
Organization Name:PRIORITY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:NADENE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACKWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-302-6992
Mailing Address - Street 1:6161 BUSCH BLVD
Mailing Address - Street 2:SUITE 309
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-2508
Mailing Address - Country:US
Mailing Address - Phone:614-557-4143
Mailing Address - Fax:614-840-0072
Practice Address - Street 1:6161 BUSCH BLVD
Practice Address - Street 2:SUITE 309
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-2508
Practice Address - Country:US
Practice Address - Phone:614-302-6992
Practice Address - Fax:614-840-0072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1750609863OtherNPI
OH315319Medicaid
OH368361Medicare Oscar/Certification