NPIMap

Organization Active NPI

United Church Homes, Inc.

Doing business as Fairhaven - Laboratory

  • Clinical Medical Laboratory
  • Upper Sandusky, OH
National Provider Identifier
1093976870
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
36D0682181 Issued in OH
Legal business name
UNITED CHURCH HOMES, INC.
Doing business as
Fairhaven - Laboratory
Practice address
850 Marseilles Ave
Upper Sandusky, OH 43351-1648
Phone
(877) 205-0018
NPI assigned
Jun 24, 2008
Last updated
Mar 11, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
UNITED CHURCH HOMES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Richard D Dible
Title
Vice President of Financial Service
Phone
(740) 223-2022

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 36D0682181 OH Primary

Addresses

Primary practice location

850 Marseilles Ave
Upper Sandusky, OH 43351-1648

Mailing address

850 Marseilles Ave
Upper Sandusky, OH 43351-1648
Phone (877) 205-0018

Other names 1

  • Fairhaven - Laboratory Doing business as

National Provider Directory

National Provider Directory
Tax ID family
United Church Homes Inc24 organizations share this tax ID, including this one
Part of
United Church Homes Inc

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615420800000",
    "number": "1093976870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 MARSEILLES AVE",
            "city": "UPPER SANDUSKY",
            "state": "OH",
            "postal_code": "433511648",
            "telephone_number": "877-205-0018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 MARSEILLES AVE",
            "city": "UPPER SANDUSKY",
            "state": "OH",
            "postal_code": "433511648",
            "telephone_number": "877-205-0018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED CHURCH HOMES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNITED CHURCH HOMES, INC.",
        "enumeration_date": "2008-06-24",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A",
        "authorized_official_last_name": "DIBLE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCIAL SERVICE",
        "authorized_official_telephone_number": "740-223-2022"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OH",
            "license": "36D0682181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairhaven - Laboratory",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fairhaven - Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Upper Sandusky, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.