Provider Demographics
NPI:1962745083
Name:MEDICAL HOUSECALLS LLC
Entity type:Organization
Organization Name:MEDICAL HOUSECALLS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-699-9090
Mailing Address - Street 1:PO BOX 32160
Mailing Address - Street 2:DEPT 107
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40232-2160
Mailing Address - Country:US
Mailing Address - Phone:513-699-9090
Mailing Address - Fax:
Practice Address - Street 1:4850 SMITH RD STE 250
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-2796
Practice Address - Country:US
Practice Address - Phone:513-699-9090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-27
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0082482Medicaid
OH0082482Medicaid