Healthcare Provider Details

I. General information

NPI: 1356884977
Provider Name (Legal Business Name): PRIMECARE HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2016
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20600 CHAGRIN BLVD STE 410
SHAKER HEIGHTS OH
44122-5340
US

IV. Provider business mailing address

20600 CHAGRIN BLVD STE 410
SHAKER HEIGHTS OH
44122-5340
US

V. Phone/Fax

Practice location:
  • Phone: 380-231-8472
  • Fax: 866-595-0043
Mailing address:
  • Phone: 380-231-8472
  • Fax: 866-595-0043

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: MR. MOHAMED HASSAN ABDILLAHI
Title or Position: CEO
Credential:
Phone: 614-525-9200