=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528407954
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FAIRFIELD HOME HEALTH AGENCY, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/19/2013
-----------------------------------------------------
Last Update Date | 08/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 700 TAYLOR RD STE 100
-----------------------------------------------------
City | GAHANNA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43230-3318
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-502-1900
-----------------------------------------------------
Fax | 614-493-0033
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 700 TAYLOR RD STE 100
-----------------------------------------------------
City | GAHANNA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43230-3318
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-502-1900
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | JAMIE SANDERS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 614-701-1713
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 2205869
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------