Provider Demographics
NPI:1881778843
Name:CLASSIC HEALTH CARE CENTER OF MILAN INC.
Entity type:Organization
Organization Name:CLASSIC HEALTH CARE CENTER OF MILAN INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:IFFT
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:330-759-2357
Mailing Address - Street 1:185 S MAIN ST
Mailing Address - Street 2:P.O. BOX 1650
Mailing Address - City:MILAN
Mailing Address - State:OH
Mailing Address - Zip Code:44846-9765
Mailing Address - Country:US
Mailing Address - Phone:419-499-2576
Mailing Address - Fax:419-499-4577
Practice Address - Street 1:185 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:OH
Practice Address - Zip Code:44846-9765
Practice Address - Country:US
Practice Address - Phone:419-499-2576
Practice Address - Fax:419-499-4577
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLASSIC HEALTH CARE CENTER OF MILAN INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-25
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5359332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies