MEDICARE: DOMINION HOME HEALTH CARE INC

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	1884127	OH

General Provider Information

NPI Number	:	1033443502
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOMINION HOME HEALTH CARE INC

Provider Business Mailing Address
First Line	:	5300 E MAIN ST
Second Line	:	SUITE 103
City	:	COLUMBUS
State	:	OH
Zip	:	43213-2580
Country	:	US
Telephone Number	:	614-866-7400
Fax Number	:	614-866-7405

Provider Business Practice Location Address
First Line	:	5300 E MAIN ST
Second Line	:	SUITE 103
City	:	COLUMBUS
State	:	OH
Zip	:	43213-2580
Country	:	US
Telephone Number	:	614-866-7400
Fax Number	:	614-866-7405

Authorized Official
Title or Position	:	OWNER
Name	:	MS. NORMA D LAUER
Credential	:	RN,BSN
Telephone Number	:	614-866-7400

Provider Enumeration Date	:	09/30/2009
Last Update Date	:	01/27/2011

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