MEDICARE: STATEWIDE HOMEHEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1366142481
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STATEWIDE HOMEHEALTH LLC

Provider Business Mailing Address
First Line	:	2700 E DUBLIN GRANVILLE RD STE LL19
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-4094
Country	:	US
Telephone Number	:	614-371-3099
Fax Number	:

Provider Business Practice Location Address
First Line	:	3055 CLEVELAND AVE STE 110
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-3602
Country	:	US
Telephone Number	:	614-371-3099
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	YUSUF FARAH
Credential	:
Telephone Number	:	614-371-3099

Provider Enumeration Date	:	03/07/2023
Last Update Date	:	06/25/2025

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Directions to “STATEWIDE HOMEHEALTH LLC ” Practice Location

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