Healthcare Provider Details

I. General information

NPI: 1467232561
Provider Name (Legal Business Name): BLUE WATER HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2023
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 SUNFOREST CT STE 200
TOLEDO OH
43623-4522
US

IV. Provider business mailing address

3950 SUNFOREST CT STE 200
TOLEDO OH
43623-4522
US

V. Phone/Fax

Practice location:
  • Phone: 419-215-1226
  • Fax:
Mailing address:
  • Phone: 419-215-1226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. MATTHEW STEPHEN BARROW JR.
Title or Position: DIRECTOR
Credential:
Phone: 419-215-1226