MEDICARE: PRISTINE HOME HEALTH 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	163WH0200X	Home Health Registered Nurse

General Provider Information

NPI Number	:	1396268686
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRISTINE HOME HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	5300 E MAIN ST STE 207
Second Line	:
City	:	WHITEHALL
State	:	OH
Zip	:	43213-2580
Country	:	US
Telephone Number	:	614-522-1699
Fax Number	:	614-522-1720

Provider Business Practice Location Address
First Line	:	5300 E MAIN ST STE 207
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-2580
Country	:	US
Telephone Number	:	614-522-1699
Fax Number	:	614-522-1720

Authorized Official
Title or Position	:	OWNER
Name	:	ROSE MADU
Credential	:	RN, BSN
Telephone Number	:	614-707-3625

Provider Enumeration Date	:	07/19/2017
Last Update Date	:	12/22/2025

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Directions to “PRISTINE HOME HEALTH CARE LLC ” Practice Location

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