MEDICARE: OHIO HEALTH HOME CARE AGENCY

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	:	1548528060
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHIO HEALTH HOME CARE AGENCY

Provider Business Mailing Address
First Line	:	PO BOX 128
Second Line	:
City	:	LEWIS CENTER
State	:	OH
Zip	:	43035-0128
Country	:	US
Telephone Number	:	614-252-4666
Fax Number	:

Provider Business Practice Location Address
First Line	:	9039 ANTARES AVE
Second Line	:	SUIT A
City	:	COLUMBUS
State	:	OH
Zip	:	43240-4067
Country	:	US
Telephone Number	:	614-252-4666
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	YARED GETACHEW
Credential	:
Telephone Number	:	614-252-4666

Provider Enumeration Date	:	05/03/2012
Last Update Date	:	05/03/2012

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