MEDICARE: ROSE OF SHARON HOME HEALTHCARE COMPANY

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	:	1578170593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROSE OF SHARON HOME HEALTHCARE COMPANY

Provider Business Mailing Address
First Line	:	321 CLAYMORE BLVD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44143-1729
Country	:	US
Telephone Number	:	216-773-3888
Fax Number	:

Provider Business Practice Location Address
First Line	:	321 CLAYMORE BLVD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44143-1729
Country	:	US
Telephone Number	:	216-773-3888
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. OLUFOLAKE A OLUWASANMI
Credential	:	CEO
Telephone Number	:	216-773-3888

Provider Enumeration Date	:	09/24/2020
Last Update Date	:	09/24/2020

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