MEDICARE: H-SHALOM HOME HEALTH 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	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093320087
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	H-SHALOM HOME HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	2821 S PARKER RD STE 1235
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80014-2713
Country	:	US
Telephone Number	:	303-332-2971
Fax Number	:

Provider Business Practice Location Address
First Line	:	2821 S PARKER RD STE 1235
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80014-2713
Country	:	US
Telephone Number	:	303-332-2971
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	MICHAEL K HAILEMARIAM
Credential	:
Telephone Number	:	303-332-2971

Provider Enumeration Date	:	09/15/2020
Last Update Date	:	05/20/2022

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