MEDICARE: MERTO HOME HEALTH AGENCY 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	:	1700115425
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MERTO HOME HEALTH AGENCY LLC

Provider Business Mailing Address
First Line	:	5252 QUEEN EIZABETH PLACE
Second Line	:
City	:	HILLIARD
State	:	OH
Zip	:	43026-9282
Country	:	US
Telephone Number	:	614-439-2373
Fax Number	:	614-771-7131

Provider Business Practice Location Address
First Line	:	5252 QUEEN EIZABETH PLACE
Second Line	:
City	:	HILLIARD
State	:	OH
Zip	:	43026-9282
Country	:	US
Telephone Number	:	614-439-2373
Fax Number	:	614-771-7131

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KHADRA SAHAL
Credential	:
Telephone Number	:	614-439-2373

Provider Enumeration Date	:	12/08/2009
Last Update Date	:	12/08/2009

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