MEDICARE: IN HOME HEALTH 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	315D00000X	Inpatient Hospice
2	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1376598284
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IN HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	333 N SUMMIT ST
Second Line	:	ATTN: DEAN SHIPMAN
City	:	TOLEDO
State	:	OH
Zip	:	43604-1531
Country	:	US
Telephone Number	:	419-254-7841
Fax Number	:	419-252-6448

Provider Business Practice Location Address
First Line	:	4536 NELSON BROGDON BLVD
Second Line	:	SUITE E-2
City	:	SUGARHILL
State	:	GA
Zip	:	30518-3478
Country	:	US
Telephone Number	:	770-614-9046
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT - REIMBURSEMENTS
Name	:	MR. BARRY A LAZARUS
Credential	:
Telephone Number	:	419-252-5541

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	10/14/2008

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Directions to “IN HOME HEALTH LLC ” Practice Location

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