Healthcare Provider Details

I. General information

NPI: 1033074315
Provider Name (Legal Business Name): CARE CHOICE HOME HEALTH AGENCY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4290 MACSWAY AVE
COLUMBUS OH
43232-4257
US

IV. Provider business mailing address

4290 MACSWAY AVE
COLUMBUS OH
43232-4257
US

V. Phone/Fax

Practice location:
  • Phone: 240-535-1462
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JOHN TAZI
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 240-535-1462