Brian Clark Thomas
Individual provider Active NPI In Home Supportive Care Agency · Laura, OH
NPI 1306563127 · NPPES record last updated Oct 24, 2022
Key facts
- NPI
- 1306563127
- Entity type
- Individual (NPI type 1)
- Primary specialty
- In Home Supportive Care Agency 253Z00000X
- Practice address
- 4121 S State Route 721
Laura, OH 45337-8779 - Phone
- (937) 750-8279
- NPI assigned
- Oct 24, 2022
- 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 |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | |||
| Transportation Broker | 347E00000X | |||
| Personal Care Attendant | 3747P1801X | |||
| In Home Supportive Care Agency | 253Z00000X | Yes |
Addresses
Primary practice location
4121 S State Route 721
Laura, OH 45337-8779
Mailing address
4121 S State Route 721
Laura, OH 45337-8779
Phone (937) 750-8279
Other providers in Laura, OH
- Dawn Lucous
- Samantha Magoto
- Ashley Miller
- Realtask Inc.
- Suzanne Lynette Ryerson
- Kristie Louise Thomas
- Cecelia L Thompson
All providers in Laura, OH · In Home Supportive Care Agency in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2022. 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.