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Organization
MOICANO HEALTHCARE PROVIDER LLC
Active
Organization
MOICANO HEALTHCARE PROVIDER LLC
Active
Other names
moicano healthcare provider llc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CALEB N LOLA I DODD (CEO)
18006176733
Entity
Organization
Contact information
Practice address
260 NORTHLAND BLVD STE 320, SPRINGDALE, OH 45246-4921
(513) 580-3109
(513) 818-9594
Mailing address
260 NORTHLAND BLVD STE 320, SPRINGDALE, OH 45246-4921
(513) 580-3109
(513) 818-9594
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
2264980
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0103628
—
OH
Enumeration date
11/10/2014
Last updated
02/10/2016
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