Provider Demographics
NPI:1235529595
Name:STONERISE HOME HEALTH SERVICES LLC
Entity type:Organization
Organization Name:STONERISE HOME HEALTH SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:STOLTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-530-1808
Mailing Address - Street 1:10123 ALLIANCE RD
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4887
Mailing Address - Country:US
Mailing Address - Phone:513-580-1808
Mailing Address - Fax:
Practice Address - Street 1:700 CHAPPELL RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-2704
Practice Address - Country:US
Practice Address - Phone:304-757-9333
Practice Address - Fax:304-757-9336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV517132Medicare PIN