Provider Demographics
NPI:1871311449
Name:WARE, MARY F
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:F
Last Name:WARE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7463 MOUNT TABOR RD LOT 12
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-9243
Mailing Address - Country:US
Mailing Address - Phone:740-672-1322
Mailing Address - Fax:
Practice Address - Street 1:7463 MOUNT TABOR RD LOT 12
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-9243
Practice Address - Country:US
Practice Address - Phone:740-672-1322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-01
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRC551475172A00000X
376J00000X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No172A00000XOther Service ProvidersDriverGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemaker