Interim Healthcare of SE Ohio Inc
Organization Active NPI Home Health Agency · Woodsfield, OH
NPI 1548302003 · NPPES record last updated Aug 27, 2024
Key facts
- NPI
- 1548302003
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- INTERIM HEALTHCARE OF SE OHIO INC
- Practice address
- 107 W Court St
Woodsfield, OH 43793-1018 - Phone
- (740) 472-9000
- Fax
- (740) 472-9002
- NPI assigned
- Feb 13, 2007
- Organization subpart
- No
Authorized official
- Name
- Thomas J Dimarco
- Title
- Chief Executive Officer
- Phone
- (614) 436-9404
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 3
Facilities with the same owner 24
Affiliated clinicians 1
-
Gina Toth, NP
Medicare Care Compare: Home health agency
- Listed as
- Interim Healthcare of Marietta
- Ownership
- Proprietary
- Certified
- Sep 2, 2004
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Home health agency certification: CCN 368066
- Legal name
- INTERIM HEALTHCARE OF SE OHIO INC
- Doing business as
- INTERIM HEALTHCARE OF MARIETTA
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Sep 2, 2004
- Last certification
- Feb 28, 2019
- Ownership / control type
- Proprietary
- Organization structure
- Corporation · Proprietary
- Enrollment address
- 107 W Court St
Woodsfield, OH 43793-1018
All disclosed owners & managing parties 6
| Name | Role | Since | Share |
|---|---|---|---|
| Rachel Maple |
W-2 Managing Employee |
Dec 14, 2024 | |
| Nicholas Reiser |
Corporate Officer |
Jan 20, 2020 | |
| Corporate Director |
Jan 20, 2020 | ||
| Salo Inc |
5% Or Greater Direct Ownership Interest | Jun 26, 2015 | 100% |
| Christine D Oswald |
5% Or Greater Indirect Ownership Interest | Jun 26, 2015 | 8.56% |
| Corporate Officer |
Jun 26, 2015 | 8.56% | |
| Corporate Director |
Jun 26, 2015 | 8.56% | |
| Thomas Joseph Dimarco |
5% Or Greater Indirect Ownership Interest | Jun 26, 2015 | 75.78% |
| Corporate Officer |
Jun 26, 2015 | 75.78% | |
| Corporate Director |
Jun 26, 2015 | 75.78% | |
| Diane S Piccard |
Corporate Officer |
Jun 26, 2015 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050120000127 | OH | Part a Provider - Home Health Agency | 7315996089 | Practice locations: Woodsfield, OH |
National Provider Directory
- Tax ID family
- Interim Healthcare of Bridgeport
Locations
252 W Main St
St Clairsvle, OH 43950
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
Addresses
Primary practice location
107 W Court St
Woodsfield, OH 43793-1018
Mailing address
300 W Wilson Bridge Rd Ste 250
Worthington, OH 43085-2289
Phone (614) 436-9404
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2556532 | Medicaid | OH |
Other names
- INTERIM HEALTHCARE OF MARIETTA
Other providers in Woodsfield, OH
- Erica Michelle Hibbitts
- Brandi Kay Hickenbottom
- Elizabeth Hull-Frye
- Jacqueline Viola Hupp
- Michelle Anne Husek
- Carolyn A Jackson
- Jason R Just
- Krista Jones
- Tiffany Marie Jones
- Jason R Just
All providers in Woodsfield, OH · Home Health 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 Aug 27, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.