MEDICARE: ELSHADDI HOME CARE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1154184315
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELSHADDI HOME CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	1911 LAFAYETTE ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15218-2414
Country	:	US
Telephone Number	:	412-791-3199
Fax Number	:

Provider Business Practice Location Address
First Line	:	1911 LAFAYETTE ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15218-2414
Country	:	US
Telephone Number	:	412-791-3199
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	OLUWAKEMI SALAKO
Credential	:
Telephone Number	:	412-791-3199

Provider Enumeration Date	:	01/31/2024
Last Update Date	:	01/31/2024

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