MEDICARE: CENTRAL OHIO HOME CARE, 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		OH

General Provider Information

NPI Number	:	1356622070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL OHIO HOME CARE, LLC

Provider Business Mailing Address
First Line	:	3590 BRANDON ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-2901
Country	:	US
Telephone Number	:	614-377-8404
Fax Number	:	614-934-7113

Provider Business Practice Location Address
First Line	:	3590 BRANDON ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-2901
Country	:	US
Telephone Number	:	614-377-8404
Fax Number	:	614-934-7113

Authorized Official
Title or Position	:	CEO
Name	:	AHMED YUSUF
Credential	:
Telephone Number	:	614-377-8404

Provider Enumeration Date	:	09/08/2011
Last Update Date	:	09/08/2011

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