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

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	:	1841916194
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	:
City	:	TOLEDO
State	:	OH
Zip	:	43604-1531
Country	:	US
Telephone Number	:	567-585-1191
Fax Number	:

Provider Business Practice Location Address
First Line	:	5041 CORPORATE WOODS DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-4375
Country	:	US
Telephone Number	:	757-490-9323
Fax Number	:

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

Provider Enumeration Date	:	10/18/2022
Last Update Date	:	10/18/2022

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