MEDICARE: SDX HOME CARE OPERATIONS, 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1508372046
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SDX HOME CARE OPERATIONS, LLC

Provider Business Mailing Address
First Line	:	1910 GARDEN SPRINGS DR STE 260
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-3664
Country	:	US
Telephone Number	:	800-387-2415
Fax Number	:

Provider Business Practice Location Address
First Line	:	1910 GARDEN SPRINGS DR STE 260
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-3664
Country	:	US
Telephone Number	:	800-387-2415
Fax Number	:

Authorized Official
Title or Position	:	VP, FINANCE
Name	:	RUTH AZANKI
Credential	:
Telephone Number	:	949-621-9649

Provider Enumeration Date	:	12/20/2017
Last Update Date	:	12/08/2020

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