MEDICARE: OASIS HOMECARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	246RP1900X	Phlebotomy Technician
2	376K00000X	Nurse's Aide
3	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1184237448
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OASIS HOMECARE LLC

Provider Business Mailing Address
First Line	:	3381 E 146TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44120-4127
Country	:	US
Telephone Number	:	216-356-2223
Fax Number	:

Provider Business Practice Location Address
First Line	:	3381 E 146TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44120-4127
Country	:	US
Telephone Number	:	216-356-2223
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JUANITA MOORE
Credential	:
Telephone Number	:	216-356-2223

Provider Enumeration Date	:	08/26/2020
Last Update Date	:	08/26/2020

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Directions to “OASIS HOMECARE LLC ” Practice Location

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