Provider Demographics
NPI:1154737997
Name:GEMINI HOMECARE
Entity type:Organization
Organization Name:GEMINI HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:937-624-9873
Mailing Address - Street 1:51 JAMESTOWN RD
Mailing Address - Street 2:PO BOX 253
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:OH
Mailing Address - Zip Code:45368-5031
Mailing Address - Country:US
Mailing Address - Phone:937-624-9873
Mailing Address - Fax:937-204-1604
Practice Address - Street 1:51 JAMESTOWN RD
Practice Address - Street 2:
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:OH
Practice Address - Zip Code:45368-5031
Practice Address - Country:US
Practice Address - Phone:937-624-9873
Practice Address - Fax:937-204-1604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-01
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.392314251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health