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General NPI Number Information
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NPI Number | 1467232561
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Entity Type | Organization
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Legal Business Name | BLUE WATER HEALTHCARE LLC
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Dates
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Enumeration Date | 10/05/2023
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 3950 SUNFOREST CT STE 200
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City | TOLEDO
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State | OH
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Zip | 43623-4522
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Country | US
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Telephone | 419-215-1226
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Fax |
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Provider Business Mailing Address
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Address Line | 3950 SUNFOREST CT STE 200
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City | TOLEDO
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State | OH
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Zip | 43623-4522
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Country | US
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Telephone | 419-215-1226
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. MATTHEW STEPHEN BARROW JR.
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Credential |
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Telephone | 419-215-1226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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