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General NPI Number Information
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NPI Number | 1588188817
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Entity Type | Organization
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Legal Business Name | MRIENA HOME HEALTHCARE AGENCY LLC
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Dates
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Enumeration Date | 07/28/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 3314 MORSE RD STE 204
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City | COLUMBUS
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State | OH
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Zip | 43231-6100
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Country | US
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Telephone | 301-693-5155
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Fax |
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Provider Business Mailing Address
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Address Line | 3314 MORSE RD STE 204
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City | COLUMBUS
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State | OH
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Zip | 43231-6100
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AWETASH TEDLA AMARE
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Credential |
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Telephone | 301-693-5155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 0000000
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License Number State | OH
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