Provider Demographics
NPI:1063539682
Name:BETHESDA CAREGIVERS
Entity type:Organization
Organization Name:BETHESDA CAREGIVERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:D
Authorized Official - Last Name:MASTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-454-4637
Mailing Address - Street 1:1330 ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-2402
Mailing Address - Country:US
Mailing Address - Phone:740-454-4741
Mailing Address - Fax:740-454-3358
Practice Address - Street 1:1330 ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-2402
Practice Address - Country:US
Practice Address - Phone:740-454-4741
Practice Address - Fax:740-454-3358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0805507Medicaid