Provider Demographics
NPI:1386403459
Name:DRTAYMOS HEALTHCARE LLC
Entity type:Organization
Organization Name:DRTAYMOS HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:OMOTAYO
Authorized Official - Middle Name:AMOS
Authorized Official - Last Name:AWOSOJI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:614-500-0341
Mailing Address - Street 1:1005 GRAY DR
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-9394
Mailing Address - Country:US
Mailing Address - Phone:614-500-0341
Mailing Address - Fax:
Practice Address - Street 1:1005 GRAY DR
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-9394
Practice Address - Country:US
Practice Address - Phone:614-500-0341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care