Provider Demographics
NPI:1053373324
Name:ACADEMY HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:ACADEMY HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NIRAJ
Authorized Official - Middle Name:J
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-293-6631
Mailing Address - Street 1:2621 WILMINGTON PIKE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45419-2454
Mailing Address - Country:US
Mailing Address - Phone:937-293-6631
Mailing Address - Fax:937-293-8104
Practice Address - Street 1:3320 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45439-2212
Practice Address - Country:US
Practice Address - Phone:937-293-6631
Practice Address - Fax:937-293-8104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0546289Medicaid
OH0546289Medicaid