MEDICARE: JAHAD RAHIM ALABOUDI

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	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1548986110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAHAD RAHIM ALABOUDI

Provider Business Mailing Address
First Line	:	2020 REILLY RUN UNIT I
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-9073
Country	:	US
Telephone Number	:	573-315-8295
Fax Number	:

Provider Business Practice Location Address
First Line	:	2020 REILLY RUN UNIT I
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-9073
Country	:	US
Telephone Number	:	573-315-8295
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2022
Last Update Date	:	10/17/2022

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