| Organization Name: | PALLADIUM HEALTHCARE, LLC. |
| NPI Number: | 1073842712 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LAWANNA ANITA PORTER (CEO) |
| Mailing Address: | 325 W 48th St Suite 3 Ashtabula |
| State: | OH US |
| Postal Code: | 440046969 |
| Phone Number: | 4409922312 |
| Fax Number: | 4409920156 |
| NPI Enumeration Date: | 12/09/2009 |
| NPI Last Update Date: | 01/04/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251F00000X |
| License Number: | 337958 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Home Infusion |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |