=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447703848
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FIRST IMPERIAL HOME HEALTH CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/02/2016
-----------------------------------------------------
Last Update Date | 08/02/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2021 E DUBLIN GRANVILLE RD SUITE 140
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43229-3568
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-601-6020
-----------------------------------------------------
Fax | 614-601-6036
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2738 STONEHENGE DR APT F
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43224-2563
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-601-6020
-----------------------------------------------------
Fax | 614-601-6036
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
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 | 201612702638
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number | 201612702638
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------