MEDICARE: TUCKER HOME HEALTHCARE 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

General Provider Information

NPI Number	:	1578076717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TUCKER HOME HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	2700 E DUBLIN GRANVILLE RD STE 280
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-4090
Country	:	US
Telephone Number	:	614-796-0939
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 E DUBLIN GRANVILLE RD STE 280
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-4090
Country	:	US
Telephone Number	:	614-796-0939
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. ABDI DAHIR
Credential	:
Telephone Number	:	614-695-9210

Provider Enumeration Date	:	11/09/2017
Last Update Date	:	02/29/2024

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