MEDICARE: ELEMENTAL HOME HEALTH CARE 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	163WH0200X	Home Health Registered Nurse

General Provider Information

NPI Number	:	1730512690
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELEMENTAL HOME HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	3310 MORSE RD
Second Line	:	SUITE 107
City	:	COLUMBUS
State	:	OH
Zip	:	43231-6191
Country	:	US
Telephone Number	:	614-441-7900
Fax Number	:	614-388-1971

Provider Business Practice Location Address
First Line	:	3310 MORSE RD
Second Line	:	SUITE 107
City	:	COLUMBUS
State	:	OH
Zip	:	43231-6191
Country	:	US
Telephone Number	:	614-441-7900
Fax Number	:	614-388-1971

Authorized Official
Title or Position	:	CEO
Name	:	FAHIMA H WARSAME
Credential	:
Telephone Number	:	614-441-7900

Provider Enumeration Date	:	08/14/2013
Last Update Date	:	08/14/2013

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