Healthcare Provider Details
I. General information
NPI: 1609890870
Provider Name (Legal Business Name): IN HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/27/2006
Last Update Date: 04/15/2022
Certification Date: 04/15/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
750 HOLIDAY DR BLDG 9, SUITE 110
PITTSBURGH PA
15220-2769
US
IV. Provider business mailing address
333 N SUMMIT ST ATTN: DEAN SHIPMAN
TOLEDO OH
43604-2615
US
V. Phone/Fax
- Phone: 412-928-2126
- Fax: 412-928-2127
- Phone: 419-254-7841
- Fax: 419-252-6448
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0002X |
| Taxonomy | Hospice and Palliative Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | 161099 |
| License Number State | PA |
VIII. Authorized Official
Name: MR.
MARTIN
D
ALLEN
Title or Position: DIRECTOR
Credential:
Phone: 419-252-5734