=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578253910
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMORCARE NURSING SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/09/2023
-----------------------------------------------------
Last Update Date | 09/02/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2575 W BROAD ST STE 5
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43204-3333
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 614-656-6100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3079 W BROAD ST STE 3
-----------------------------------------------------
City | COLUMBUS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43204-1397
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMIN
-----------------------------------------------------
Name | SULEKHA MOHAMED
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 614-656-6100
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------