Provider Demographics
NPI:1487723110
Name:INHOME INFUSION SVCS AT OHIO REG HOSP
Entity type:Organization
Organization Name:INHOME INFUSION SVCS AT OHIO REG HOSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN DIRECTOR OF ONCOLOGY
Authorized Official - Prefix:
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBERTINI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH MBA
Authorized Official - Phone:740-633-4324
Mailing Address - Street 1:90 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MARTINS FERRY
Mailing Address - State:OH
Mailing Address - Zip Code:43935-1648
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:90 N 4TH ST
Practice Address - Street 2:
Practice Address - City:MARTINS FERRY
Practice Address - State:OH
Practice Address - Zip Code:43935-1648
Practice Address - Country:US
Practice Address - Phone:740-633-4112
Practice Address - Fax:740-633-4553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0208506503336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0147455000Medicaid
3660619OtherOTHER ID NUMBER
OH0169400Medicaid
0392180001Medicare NSC