Provider Demographics
NPI:1407272099
Name:DOMINION HOME HEALTH AGENCY
Entity type:Organization
Organization Name:DOMINION HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:MABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AGGOE-OPOKU
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:614-209-9340
Mailing Address - Street 1:3955 SNOWSHOE AVE
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-1198
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3955 SNOWSHOE AVE
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-1198
Practice Address - Country:US
Practice Address - Phone:614-209-9340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health