Provider Demographics
NPI:1306899331
Name:SSTH, LLC
Entity type:Organization
Organization Name:SSTH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:W
Authorized Official - Last Name:HANNERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-884-0793
Mailing Address - Street 1:739 S JAMES RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43227-1098
Mailing Address - Country:US
Mailing Address - Phone:614-884-0793
Mailing Address - Fax:614-884-0795
Practice Address - Street 1:739 S JAMES RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43227-1098
Practice Address - Country:US
Practice Address - Phone:614-884-0793
Practice Address - Fax:614-884-0795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2292120Medicaid
OH2292120Medicaid