Ryan Jacob Podach
Individual provider Active NPI Home Health Aide · Bloomdale, OH
NPI 1174867568 · NPPES record last updated Nov 26, 2012
Key facts
- NPI
- 1174867568
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Aide 374U00000X
- Practice address
- 212 N Maple St
Bloomdale, OH 44817-0026 - Phone
- (419) 619-1375
- NPI assigned
- Nov 26, 2012
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | Yes |
Addresses
Primary practice location
212 N Maple St
Bloomdale, OH 44817-0026
Mailing address
PO Box 26
Bloomdale, OH 44817-0026
Phone (419) 619-1375
Other providers in Bloomdale, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 26, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.