MEDICARE: CLASSICS HEALTHCARE 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1194671131
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLASSICS HEALTHCARE SERVICES LLC

Provider Business Mailing Address
First Line	:	8752 STONEHOUSE DR
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-1931
Country	:	US
Telephone Number	:	433-420-5615
Fax Number	:

Provider Business Practice Location Address
First Line	:	8752 STONEHOUSE DR
Second Line	:
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-1931
Country	:	US
Telephone Number	:	433-420-5615
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	MR. TIMOTHY OLUWAYINKA OMOBOYE
Credential	:	MD
Telephone Number	:	410-772-4329

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/10/2026

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