Healthcare Provider Details

I. General information

NPI: 1437770617
Provider Name (Legal Business Name): HUSSEIN ALI ELMI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2020
Last Update Date: 10/18/2023
Certification Date: 10/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2376 ATWOOD TER
COLUMBUS OH
43211-2030
US

IV. Provider business mailing address

2376 ATWOOD TER
COLUMBUS OH
43211-2030
US

V. Phone/Fax

Practice location:
  • Phone: 304-437-9387
  • Fax:
Mailing address:
  • Phone: 304-437-9387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number9AUSO
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number9AUSO
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License NumberTA181308
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number9AUSO
License Number StateWV
# 5
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number9AUSO
License Number StateWV
# 6
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateOH
# 7
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateOH
# 8
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateOH
# 9
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License NumberTA181308
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: