Provider Demographics
NPI:1871788042
Name:NEIDIG HEALTH CARE LTD
Entity type:Organization
Organization Name:NEIDIG HEALTH CARE LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFEREY
Authorized Official - Middle Name:
Authorized Official - Last Name:NEIDIG
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:740-498-6337
Mailing Address - Street 1:PO BOX 1023
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663
Mailing Address - Country:US
Mailing Address - Phone:740-498-6337
Mailing Address - Fax:740-498-8037
Practice Address - Street 1:245 W STATE ST
Practice Address - Street 2:
Practice Address - City:NEWCOMERSTOWN
Practice Address - State:OH
Practice Address - Zip Code:43832-1411
Practice Address - Country:US
Practice Address - Phone:740-498-6337
Practice Address - Fax:740-498-8037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
OH0217497003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2081069OtherPK
OH22659Medicaid
OH2772950Medicaid
4510470003Medicare NSC