MEDICARE: BEDROCK HOME HEALTHCARE

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	:	1518773969
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEDROCK HOME HEALTHCARE

Provider Business Mailing Address
First Line	:	9701 BROOKPARK RD STE 10
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44129-6824
Country	:	US
Telephone Number	:	216-712-4160
Fax Number	:	888-607-9054

Provider Business Practice Location Address
First Line	:	9701 BROOKPARK RD STE 10
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44129-6824
Country	:	US
Telephone Number	:	216-712-4160
Fax Number	:	888-607-9054

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	AHMED ISSACK
Credential	:
Telephone Number	:	614-586-5970

Provider Enumeration Date	:	12/09/2024
Last Update Date	:	12/09/2024

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Directions to “BEDROCK HOME HEALTHCARE ” Practice Location

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