Healthcare Provider Details

I. General information

NPI: 1235082801
Provider Name (Legal Business Name): BRIDGEWAY HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2026
Last Update Date: 02/16/2026
Certification Date: 02/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 RIDDLER RIDGE DR
BLACKLICK OH
43004-7158
US

IV. Provider business mailing address

645 RIDDLER RIDGE DR
BLACKLICK OH
43004-7158
US

V. Phone/Fax

Practice location:
  • Phone: 614-452-1162
  • Fax:
Mailing address:
  • Phone: 614-452-1162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ABDINASIR ALI AHMED
Title or Position: CEO
Credential:
Phone: 614-452-1162