MEDICARE: IDOWU OKE

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	:	1316765688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IDOWU OKE

Provider Business Mailing Address
First Line	:	625 DURANGO DR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43609-1705
Country	:	US
Telephone Number	:	248-778-5616
Fax Number	:

Provider Business Practice Location Address
First Line	:	625 DURANGO DR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43609-1705
Country	:	US
Telephone Number	:	248-778-5616
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2024
Last Update Date	:	09/26/2024

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Directions to “ IDOWU OKE ” Practice Location

Language	Start Address	Practice Location

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