MEDICARE: IN HOME HEALTH 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	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician
2	251G00000X	Community Based Hospice Care Agency	2001311	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700105152
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IN HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	333 N SUMMIT ST
Second Line	:	DEAN SHIPMAN
City	:	TOLEDO
State	:	OH
Zip	:	43604-2615
Country	:	US
Telephone Number	:	419-254-7841
Fax Number	:	419-254-5494

Provider Business Practice Location Address
First Line	:	333 SALEM PL
Second Line	:	SUITE 165
City	:	FAIRVIEW HEIGHTS
State	:	IL
Zip	:	62208-1341
Country	:	US
Telephone Number	:	618-632-0304
Fax Number	:	618-632-0364

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. MARTIN D ALLEN
Credential	:
Telephone Number	:	419-252-5734

Provider Enumeration Date	:	05/25/2010
Last Update Date	:	04/15/2022

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Directions to “IN HOME HEALTH LLC ” Practice Location

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