MEDICARE: ELDERHEALTH HOME CARE LTD.

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

General Provider Information

NPI Number	:	1568742484
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELDERHEALTH HOME CARE LTD.

Provider Business Mailing Address
First Line	:	4560 N HIGH ST STE 200
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-2638
Country	:	US
Telephone Number	:	614-261-7600
Fax Number	:	614-261-7606

Provider Business Practice Location Address
First Line	:	4560 N HIGH ST STE 200
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-2638
Country	:	US
Telephone Number	:	614-261-7600
Fax Number	:	614-261-7606

Authorized Official
Title or Position	:	CEO
Name	:	MS. KIMBERLY C PAYNE
Credential	:	MSPT
Telephone Number	:	614-261-7600

Provider Enumeration Date	:	08/23/2011
Last Update Date	:	08/23/2011

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