MEDICARE: INNOVATIVE HOME HEALTH PRACTICE 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	251E00000X	Home Health Agency		OH

General Provider Information

NPI Number	:	1902197999
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNOVATIVE HOME HEALTH PRACTICE LLC

Provider Business Mailing Address
First Line	:	2246 S HAMILTON RD STE 204
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4317
Country	:	US
Telephone Number	:	614-914-8330
Fax Number	:	614-914-8335

Provider Business Practice Location Address
First Line	:	2246 S HAMILTON RD STE 204
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4317
Country	:	US
Telephone Number	:	614-914-8330
Fax Number	:	614-914-8335

Authorized Official
Title or Position	:	CEO
Name	:	MS. THERESAH AMPONSAH
Credential	:
Telephone Number	:	614-914-8330

Provider Enumeration Date	:	04/25/2011
Last Update Date	:	01/23/2025

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