MEDICARE: INDEPENDENCE HOME HEALTH CARE

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

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	:	1326725508
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INDEPENDENCE HOME HEALTH CARE

Provider Business Mailing Address
First Line	:	3505 E LIVINGSTON AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43227-2252
Country	:	US
Telephone Number	:	614-615-6639
Fax Number	:

Provider Business Practice Location Address
First Line	:	3505 E LIVINGSTON AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43227-2252
Country	:	US
Telephone Number	:	614-615-6639
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	OUMOU SY
Credential	:
Telephone Number	:	614-615-6639

Provider Enumeration Date	:	06/29/2023
Last Update Date	:	06/29/2023

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Directions to “INDEPENDENCE HOME HEALTH CARE ” Practice Location

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