Healthcare Provider Details

I. General information

NPI: 1396268686
Provider Name (Legal Business Name): PRISTINE HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2017
Last Update Date: 03/14/2026
Certification Date: 03/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 E MAIN ST STE 207
COLUMBUS OH
43213-2580
US

IV. Provider business mailing address

5300 E MAIN ST STE 207
WHITEHALL OH
43213-2580
US

V. Phone/Fax

Practice location:
  • Phone: 614-522-1699
  • Fax: 614-522-1720
Mailing address:
  • Phone: 614-522-1699
  • Fax: 614-522-1720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ROSE MADU
Title or Position: OWNER
Credential: RN, BSN
Phone: 614-707-3625