=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144551201
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | IVORY HOME HEALTH SERVICES INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/28/2010
-----------------------------------------------------
Last Update Date | 05/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6488 E MAIN ST STE C
-----------------------------------------------------
City | REYNOLDSBURG
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43068-7305
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-221-5035
-----------------------------------------------------
Fax | 614-502-7718
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6488 E MAIN ST STE C
-----------------------------------------------------
City | REYNOLDSBURG
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43068-7305
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-221-5035
-----------------------------------------------------
Fax | 614-502-7718
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. ARJUN SUBEDI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 614-707-6432
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------