Organization
COUNTY OF BUTLER
Active
Other names
Butler County Care Facility
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES DEMIDOVICH (ADMINISTRATOR)
(513) 887-3728
Entity
Organization
Contact information
Practice address
1800 PRINCETON RD, HAMILTON, OH 45011-4742
(513) 887-3728
(513) 785-6627
Mailing address
1800 PRINCETON RD, HAMILTON, OH 45011-4742
(513) 887-3728
(513) 785-6627
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
N/A
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0321691
—
OH
01
—
4944900001
DME PROVIDER NUMBER
OH
Enumeration date
09/15/2005
Last updated
01/12/2011
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