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Contact Information

AETNA PROVIDER SERVICE
8514 ARLEN DRIVE
BLACKLICK, OH43004
 Phone: 614-946-5475
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

In Home Supportive Care

253Z00000X
Indicates primary specialty

NPI Profile & details for AETNA PROVIDER SERVICE

NPI # 1770972143
LBN Legal business name AETNA PROVIDER SERVICE
Authorized official MEMUNATU SHERIFF - (INDEPENDENT PROVIDER)
Entity Organization
Organization subpart 1 No
Enumeration date 01/22/2015
Last updated 01/22/2015 - About 11 years ago
Identifiers
OH License # 2366658
OH Medicaid 2366658
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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