MEDICARE: STATNURSE HOME HEALTH INC.

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		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	:	1316031776
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STATNURSE HOME HEALTH INC.

Provider Business Mailing Address
First Line	:	5524 HILLIARD ROME OFFICE PARK
Second Line	:
City	:	HILLIARD
State	:	OH
Zip	:	43026-7286
Country	:	US
Telephone Number	:	614-464-3325
Fax Number	:	844-724-3325

Provider Business Practice Location Address
First Line	:	5524 HILLIARD ROME OFFICE PARK
Second Line	:
City	:	HILLIARD
State	:	OH
Zip	:	43026-7286
Country	:	US
Telephone Number	:	614-464-3325
Fax Number	:	844-724-3325

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN ROSE
Credential	:
Telephone Number	:	937-830-3544

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	06/18/2014

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