MEDICARE: PROFESSIONAL HOME HEALTH CARE 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	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831199306
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROFESSIONAL HOME HEALTH CARE INC

Provider Business Mailing Address
First Line	:	1629 HARVARD ST
Second Line	:
City	:	LONGMONT
State	:	CO
Zip	:	80503-2219
Country	:	US
Telephone Number	:	720-494-0190
Fax Number	:	720-864-2839

Provider Business Practice Location Address
First Line	:	1040 S 8TH ST
Second Line	:	SUITE 201
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80905-7364
Country	:	US
Telephone Number	:	719-532-0373
Fax Number	:	720-864-2839

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. SHERYL A BELLINGER
Credential	:
Telephone Number	:	720-530-5492

Provider Enumeration Date	:	07/27/2005
Last Update Date	:	08/21/2020

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