MEDICARE: FAMILY HEALTHCARE CENTER, 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	200501200630	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275683476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY HEALTHCARE CENTER, LLC

Provider Business Mailing Address
First Line	:	1150 MORSE RD STE 206
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-6327
Country	:	US
Telephone Number	:	614-436-6568
Fax Number	:	614-436-3268

Provider Business Practice Location Address
First Line	:	1150 MORSE RD
Second Line	:	SUITE # 206
City	:	COLUMBUS
State	:	OH
Zip	:	43229-6327
Country	:	US
Telephone Number	:	614-436-6568
Fax Number	:	614-436-3268

Authorized Official
Title or Position	:	ADMINSTRATOR
Name	:	FUAD YUSSUF
Credential	:
Telephone Number	:	614-436-6568

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	09/02/2016

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