=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144205931
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OHIO HOME HEALTH CARE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/14/2005
-----------------------------------------------------
Last Update Date | 10/10/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5050 NEBRASKA AVE SUITE 5
-----------------------------------------------------
City | HUBER HEIGHTS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45424-6197
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-853-0271
-----------------------------------------------------
Fax | 937-853-0274
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5050 NEBRASKA AVE SUITE 5
-----------------------------------------------------
City | HUBER HEIGHTS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45424-6197
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 937-853-0271
-----------------------------------------------------
Fax | 937-853-0274
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MR. SIDNEY S. SIEGEL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 937-853-0271
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 1303426
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------