Healthcare Provider Details

I. General information

NPI: 1740912807
Provider Name (Legal Business Name): INNERCARE CAREGIVER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2022
Last Update Date: 06/28/2022
Certification Date: 06/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 E DUBLIN GRANVILLE RD STE 211
COLUMBUS OH
43229-3312
US

IV. Provider business mailing address

26 RUSHKA CT
WESTERVILLE OH
43081-2830
US

V. Phone/Fax

Practice location:
  • Phone: 614-695-8220
  • Fax: 614-695-8220
Mailing address:
  • Phone: 614-589-3204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MS. NKEIRUKA M OKORO
Title or Position: PRESIDENT/ALTERNATE ADMINISTRATOR
Credential:
Phone: 614-589-3204