MEDICARE: OPTIMUM HOME HEALTH SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		OH

General Provider Information

NPI Number	:	1013121318
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMUM HOME HEALTH SERVICES, LLC

Provider Business Mailing Address
First Line	:	3556 SULLIVANT AVENUE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43228
Country	:	US
Telephone Number	:	614-458-1868
Fax Number	:	614-458-1869

Provider Business Practice Location Address
First Line	:	3556 SULLIVANT AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204-1153
Country	:	US
Telephone Number	:	614-458-1868
Fax Number	:	614-458-1869

Authorized Official
Title or Position	:	OWNER
Name	:	MOHAMED BATUN
Credential	:	CPA
Telephone Number	:	614-458-1868

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	08/22/2020

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