Healthcare Provider Details

I. General information

NPI: 1639858756
Provider Name (Legal Business Name): ABDULAZIZ ALMADAOJI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2023
Last Update Date: 07/17/2023
Certification Date: 07/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 MAIN ST
HAMILTON OH
45013-4717
US

IV. Provider business mailing address

426 MAIN ST
HAMILTON OH
45013-4717
US

V. Phone/Fax

Practice location:
  • Phone: 937-474-6241
  • Fax:
Mailing address:
  • Phone: 937-474-6241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: