Provider Demographics
NPI:1063829588
Name:TOSH HEALTH SERVICES LLC
Entity type:Organization
Organization Name:TOSH HEALTH SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:OSARETIN
Authorized Official - Last Name:EDOSOMWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-443-1743
Mailing Address - Street 1:3921 CAMERON CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-6772
Mailing Address - Country:US
Mailing Address - Phone:704-443-1743
Mailing Address - Fax:
Practice Address - Street 1:3921 CAMERON CREEK DRIVE
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-6772
Practice Address - Country:US
Practice Address - Phone:704-443-1743
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOSH HEALTH SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC=========OtherPRIVATE INSURANCE
NC=========Medicaid