Aetna Provider Service
Organization Active NPI In Home Supportive Care Agency · Blacklick, OH
NPI 1770972143 · NPPES record last updated Jan 22, 2015
Key facts
- NPI
- 1770972143
- Entity type
- Organization (NPI type 2)
- Primary specialty
- In Home Supportive Care Agency 253Z00000X
- License
- 2366658 (OH)
- Legal business name
- AETNA PROVIDER SERVICE
- Practice address
- 8514 Arlen Drive
Blacklick, OH 43004 - Phone
- (614) 946-5475
- NPI assigned
- Jan 22, 2015
- Organization subpart
- No
Authorized official
- Name
- Memunatu Sheriff
- Title
- Independent Provider
- Phone
- (614) 946-5475
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | 2366658 | OH | Yes |
Addresses
Primary practice location
8514 Arlen Drive
Blacklick, OH 43004
Mailing address
8514 Arlen Dr
Blacklick, OH 43004-8155
Phone (614) 946-5475
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2366658 | Medicaid | OH |
Other providers in Blacklick, OH
- Rebecca Adams
- Sarah Adams
- Comfort B Addo
- Omotayo Adesiji
- Nana Akwasi Adu-Poku
- Agency for Your Services and Cares Inc
- Sarah Kafui Aheto
- Rahim Ahmed
- Grace Kakie Awo Aidoo
- Valentina O Akindele
All providers in Blacklick, 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 Jan 22, 2015. 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.