MEDICARE: MARWAH HOME CARE 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	163WH0200X	Home Health Registered Nurse

General Provider Information

NPI Number	:	1851998843
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARWAH HOME CARE LLC

Provider Business Mailing Address
First Line	:	3720 KERSDALE PL
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-8611
Country	:	US
Telephone Number	:	614-615-2946
Fax Number	:

Provider Business Practice Location Address
First Line	:	3720 KERSDALE PL
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-8611
Country	:	US
Telephone Number	:	614-615-2946
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ABDISALAN HUBOR
Credential	:
Telephone Number	:	614-615-2946

Provider Enumeration Date	:	10/03/2020
Last Update Date	:	10/03/2020

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