MEDICARE: GREAT DIRECT CARE 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	253Z00000X	In Home Supportive Care Agency
2	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3706HHN	OTHER	OH	HHA

General Provider Information

NPI Number	:	1053127316
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREAT DIRECT CARE LLC

Provider Business Mailing Address
First Line	:	1604 E PERKINS AVE STE 104
Second Line	:
City	:	SANDUSKY
State	:	OH
Zip	:	44870-5123
Country	:	US
Telephone Number	:	732-429-2150
Fax Number	:

Provider Business Practice Location Address
First Line	:	1604 E PERKINS AVE STE 104
Second Line	:
City	:	SANDUSKY
State	:	OH
Zip	:	44870-5123
Country	:	US
Telephone Number	:	732-429-2150
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. RUSHIK PATEL
Credential	:
Telephone Number	:	732-429-2150

Provider Enumeration Date	:	12/10/2024
Last Update Date	:	03/18/2026

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Directions to “GREAT DIRECT CARE LLC ” Practice Location

Language	Start Address	Practice Location

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