MEDICARE: ACCESS SENIOR HOMECARE 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	SD034892	OH

General Provider Information

NPI Number	:	1336428085
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCESS SENIOR HOMECARE LLC

Provider Business Mailing Address
First Line	:	4937 WEST BROAD STREET
Second Line	:	SUITE 101
City	:	COLUMBUS
State	:	OH
Zip	:	43228
Country	:	US
Telephone Number	:	614-439-0007
Fax Number	:	614-515-5913

Provider Business Practice Location Address
First Line	:	4937 W BROAD ST
Second Line	:	SUITE 101
City	:	COLUMBUS
State	:	OH
Zip	:	43228-1646
Country	:	US
Telephone Number	:	614-439-0007
Fax Number	:	614-515-5913

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ASHA M HUSSEIN
Credential	:
Telephone Number	:	614-439-0007

Provider Enumeration Date	:	08/12/2011
Last Update Date	:	08/29/2011

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