MEDICARE: HEBRON AT HOME MINISTRIES

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	:	1255092870
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEBRON AT HOME MINISTRIES

Provider Business Mailing Address
First Line	:	8637 STATAE ROUTE 41
Second Line	:
City	:	WEST UNION
State	:	OH
Zip	:	45693-8500
Country	:	US
Telephone Number	:	937-779-5359
Fax Number	:	888-244-5358

Provider Business Practice Location Address
First Line	:	8637 STATE ROUTE 41
Second Line	:
City	:	WEST UNION
State	:	OH
Zip	:	45693-8962
Country	:	US
Telephone Number	:	937-779-5399
Fax Number	:	888-244-5358

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	SUSAN CARLEN-EDWARDS
Credential	:
Telephone Number	:	727-270-4921

Provider Enumeration Date	:	01/05/2022
Last Update Date	:	08/15/2022

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Directions to “HEBRON AT HOME MINISTRIES ” Practice Location

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