MEDICARE: PLANET CARE HOME HEALTH SERVICES

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	:	1194134767
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLANET CARE HOME HEALTH SERVICES

Provider Business Mailing Address
First Line	:	PO BOX 241517
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44124-8517
Country	:	US
Telephone Number	:	440-229-5855
Fax Number	:	440-448-4903

Provider Business Practice Location Address
First Line	:	5813 MAYFIELD RD
Second Line	:	SUITE 205
City	:	CLEVELAND
State	:	OH
Zip	:	44124-2932
Country	:	US
Telephone Number	:	440-229-5855
Fax Number	:	440-448-4903

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. OLGA RUSTAMOV
Credential	:	RN
Telephone Number	:	440-229-5855

Provider Enumeration Date	:	08/07/2014
Last Update Date	:	08/07/2014

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Directions to “PLANET CARE HOME HEALTH SERVICES ” Practice Location

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