Organization
CLASSIC HEALTH CARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT FOSNAUGH (COORDINATOR)
(614) 848-3900
Entity
Organization
Contact information
Practice address
788 BUSCH CT, COLUMBUS, OH 43229-1704
(614) 848-3900
(614) 848-3901
Mailing address
788 BUSCH CT, COLUMBUS, OH 43229-1704
(614) 848-3900
(614) 848-3901
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2939306
ODJFS MEDICAID PROVIDER NUMBER
OH
Enumeration date
01/12/2010
Last updated
04/29/2010
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