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HOME HEALTH MDS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
UGOALA C BANKS MD (MEDICAL DIRECTOR)
(513) 505-6309
Entity
Organization

Contact information

Practice address
464 ATTLEBORO CT, MASON, OH 45040-2213
(513) 667-9251
Mailing address
PO BOX 316, KINGS MILLS, OH 45034-0316
(513) 667-9251
(513) 486-1868

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary

Other

Enumeration date
12/16/2021
Last updated
07/10/2023
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