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NPI Code Detail

MEDICARE: OMNICARE HOME HEALTH, LLC

MEDICARE: OMNICARE HOME HEALTH, 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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1538008693
Entity Type Code : Organization
Provider Name (Legal Business Name) : OMNICARE HOME HEALTH, LLC
Provider Business Mailing Address
First Line : 1416 CRAZY HORSE LN APT 202
Second Line :
City : LOUISVILLE
State : KY
Zip : 40243-3907
Country : US
Telephone Number : 216-346-3341
Fax Number :
Provider Business Practice Location Address
First Line : 2375 PROFESSIONAL HEIGHTS DR STE 210
Second Line :
City : LEXINGTON
State : KY
Zip : 40503-3040
Country : US
Telephone Number : 216-346-3341
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. JONATHAN CHRISTOPHER TYES
Credential : MD
Telephone Number : 216-346-3341
Provider Enumeration Date : 03/25/2026
Last Update Date : 03/25/2026

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Directions to “OMNICARE HOME HEALTH, LLC ” Practice Location

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