MEDICARE: OMNICARE HOME HEALTHCARE AGENCY, 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	40323953	OTHER	OH	ODA PROVIDER NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508881913
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OMNICARE HOME HEALTHCARE AGENCY, LLC

Provider Business Mailing Address
First Line	:	1148 MORNING GLORY DR
Second Line	:
City	:	MACEDONIA
State	:	OH
Zip	:	44056-4305
Country	:	US
Telephone Number	:	330-459-0398
Fax Number	:	330-748-4660

Provider Business Practice Location Address
First Line	:	23611 CHAGRIN BLVD STE 120
Second Line	:
City	:	BEACHWOOD
State	:	OH
Zip	:	44122-5540
Country	:	US
Telephone Number	:	216-292-6352
Fax Number	:	330-748-4660

Authorized Official
Title or Position	:	PRESIDENT CEO
Name	:	MR. CHRISTIAN N OCHEI
Credential	:
Telephone Number	:	330-459-0398

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	03/08/2024

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