Healthcare Provider Details

I. General information

NPI: 1841546926
Provider Name (Legal Business Name): FIDELITY HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2012
Last Update Date: 06/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6650 S 84TH AVE STE 100A
OMAHA NE
68127
US

IV. Provider business mailing address

6650 S 84TH AVE STE 100A
OMAHA NE
68127-4105
US

V. Phone/Fax

Practice location:
  • Phone: 402-884-9581
  • Fax: 402-763-9126
Mailing address:
  • Phone: 402-884-9581
  • Fax: 402-763-9126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNE

VIII. Authorized Official

Name: MRS. CAROLINE TOUMGUE ANUH-NDUMU
Title or Position: PRESIDENT/OWNER
Credential: RN,BSN
Phone: 402-301-8731