MEDICARE: INTERIM HEALTHCARE OF OHIO

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

General Provider Information

NPI Number	:	1073715926
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERIM HEALTHCARE OF OHIO

Provider Business Mailing Address
First Line	:	784 MORRISON RD
Second Line	:
City	:	GAHANNA
State	:	OH
Zip	:	43230-6642
Country	:	US
Telephone Number	:	614-888-3130
Fax Number	:	614-888-3686

Provider Business Practice Location Address
First Line	:	784 MORRISON RD
Second Line	:
City	:	GAHANNA
State	:	OH
Zip	:	43230-6642
Country	:	US
Telephone Number	:	614-888-3130
Fax Number	:	614-888-3686

Authorized Official
Title or Position	:	FINANCE MANAGER
Name	:	MR. RICHARD FREDERICK NIELSEN
Credential	:
Telephone Number	:	614-880-2926

Provider Enumeration Date	:	06/04/2007
Last Update Date	:	06/05/2009

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Directions to “INTERIM HEALTHCARE OF OHIO ” Practice Location

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