Provider Demographics
NPI:1124242466
Name:PRUDENT HEALTHCARE SERVICES, LLC
Entity type:Organization
Organization Name:PRUDENT HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:ETHEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:FREEMAN-NNONAH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:614-404-6599
Mailing Address - Street 1:3280 MORSE RD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-6175
Mailing Address - Country:US
Mailing Address - Phone:614-404-6599
Mailing Address - Fax:614-837-6335
Practice Address - Street 1:5659 EARNINGS DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-7431
Practice Address - Country:US
Practice Address - Phone:614-404-6599
Practice Address - Fax:614-837-6335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health