| Interim Healthcare Palliative Care Of The Midwest, Inc | |
|
300 W Wilson Bridge Rd Ste 250 Worthington OH 43085-2289 | |
| (614) 436-9404 | |
| Not Available |
| Full Name | Interim Healthcare Palliative Care Of The Midwest, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 300 W Wilson Bridge Rd Ste 250, Worthington, Ohio |
| Authorized Official Name and Position | Thomas J Dimarco (CEO) |
| Authorized Official Contact | 6144369404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Interim Healthcare Palliative Care Of The Midwest, Inc 300 W Wilson Bridge Rd Ste 250 Worthington OH 43085-2289 Ph: (614) 436-9404 | Interim Healthcare Palliative Care Of The Midwest, Inc 300 W Wilson Bridge Rd Ste 250 Worthington OH 43085-2289 Ph: (614) 436-9404 |
| NPI Number | 1851911440 |
|---|---|
| Provider Enumeration Date | 04/23/2020 |
| Last Update Date | 08/29/2024 |
| Certification Date | 08/29/2024 |
| Medicare PECOS PAC ID | 4688085301 |
|---|---|
| Medicare Enrollment ID | O20201201000816 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851911440 | NPI | - | NPPES |
| Provider Name | Sarah H Bonza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487694709 PECOS PAC ID: 2264527142 Enrollment ID: I20071008000256 |
| Provider Name | Jennifer L Datta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083676969 PECOS PAC ID: 1254315971 Enrollment ID: I20110119000713 |
| Provider Name | Jenifer M Eubanks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669729885 PECOS PAC ID: 3870741663 Enrollment ID: I20120920000239 |
| Provider Name | Erica Moses |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700373990 PECOS PAC ID: 5395009831 Enrollment ID: I20180508002778 |
| Provider Name | Melissa Mccuistion |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376169631 PECOS PAC ID: 3375963143 Enrollment ID: I20201015002655 |
| Provider Name | Nicole Marie Hershey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912501073 PECOS PAC ID: 0547598583 Enrollment ID: I20210204003047 |
| Provider Name | Becky Tasch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679163240 PECOS PAC ID: 9931517695 Enrollment ID: I20210416002008 |
| Provider Name | Jason Bryant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124470935 PECOS PAC ID: 1355638388 Enrollment ID: I20210427002762 |
| Provider Name | Dana N Frazier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316422413 PECOS PAC ID: 6305249608 Enrollment ID: I20210723002457 |
| Provider Name | Rebekka Lindamood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447912134 PECOS PAC ID: 3173919529 Enrollment ID: I20220412000192 |
| Provider Name | Nicole M Demastry Kolikohn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114517828 PECOS PAC ID: 3678957602 Enrollment ID: I20220825000757 |
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