MEDICARE: PRECEDENCE HOME HEALTHCARE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	251F00000X	Home Infusion Agency
3	251G00000X	Community Based Hospice Care Agency
4	343900000X	Non-emergency Medical Transport (VAN)
5	385H00000X	Respite Care
6	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
7	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1295074979
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECEDENCE HOME HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	4663 EXECUTIVE DR STE 17
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-3627
Country	:	US
Telephone Number	:	614-827-3222
Fax Number	:	614-259-6048

Provider Business Practice Location Address
First Line	:	4663 EXECUTIVE DR STE 17
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-3627
Country	:	US
Telephone Number	:	800-413-0553
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. NANA KWESI BOTCHWAY BAISEL
Credential	:	OWNER
Telephone Number	:	614-218-7509

Provider Enumeration Date	:	01/31/2013
Last Update Date	:	01/10/2022

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