Provider Demographics
NPI:1699710715
Name:MADISON, ARGENTINA CHAWNTE
Entity type:Individual
Prefix:
First Name:ARGENTINA
Middle Name:CHAWNTE
Last Name:MADISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1936 OWENDALE DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45439-2632
Mailing Address - Country:US
Mailing Address - Phone:937-648-7337
Mailing Address - Fax:
Practice Address - Street 1:1936 OWENDALE DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45439-2632
Practice Address - Country:US
Practice Address - Phone:937-648-7337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5706801Medicaid