MEDICARE: VANGUARD HOME HEALTH CARE INC

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	:	1588717615
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VANGUARD HOME HEALTH CARE INC

Provider Business Mailing Address
First Line	:	3314 MORSE RD STE 208
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-6100
Country	:	US
Telephone Number	:	614-376-9161
Fax Number	:	614-342-2615

Provider Business Practice Location Address
First Line	:	3314 MORSE RD STE 208
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-6100
Country	:	US
Telephone Number	:	614-376-9161
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. ABDIKARIM ALI OMAR
Credential	:
Telephone Number	:	614-414-7375

Provider Enumeration Date	:	01/20/2007
Last Update Date	:	05/06/2019

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