=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336225960
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INDEPENDENT HOME CARE INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/27/2006
-----------------------------------------------------
Last Update Date | 03/20/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4371 E BROAD ST SUITE 101
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43213-1248
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-231-9202
-----------------------------------------------------
Fax | 614-231-9242
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4371 E BROAD ST SUITE 101
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43213-1248
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-231-9202
-----------------------------------------------------
Fax | 614-231-9242
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DON
-----------------------------------------------------
Name | LINNA MORGAN
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 614-778-1608
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------