Provider Demographics
NPI:1215090758
Name:PLATINUM HOME HEALTH SERVICES
Entity type:Organization
Organization Name:PLATINUM HOME HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:VASIL
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:440-229-5822
Mailing Address - Street 1:PO BOX 361098
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-0019
Mailing Address - Country:US
Mailing Address - Phone:440-229-5822
Mailing Address - Fax:440-995-0222
Practice Address - Street 1:5813 MAYFIELD RD STE 201
Practice Address - Street 2:
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-2937
Practice Address - Country:US
Practice Address - Phone:440-995-0202
Practice Address - Fax:440-995-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH368135251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH368135Medicare ID - Type UnspecifiedMEDICARE NUMBER