MEDICARE: WAYNE HOME CARE AGENCY INC.

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1477260230
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WAYNE HOME CARE AGENCY INC.

Provider Business Mailing Address
First Line	:	3007 E STATE BLVD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46805-4736
Country	:	US
Telephone Number	:	260-445-7752
Fax Number	:

Provider Business Practice Location Address
First Line	:	3007 E STATE BLVD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46805-4736
Country	:	US
Telephone Number	:	260-445-7752
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	AUSTIN RAMSEY
Credential	:
Telephone Number	:	260-445-7752

Provider Enumeration Date	:	11/01/2022
Last Update Date	:	06/07/2023

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