MEDICARE: MATRIX HOME 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1871150920
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MATRIX HOME CARE LLC

Provider Business Mailing Address
First Line	:	1015 E BROAD ST STE A
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43205-1370
Country	:	US
Telephone Number	:	614-822-9055
Fax Number	:

Provider Business Practice Location Address
First Line	:	1015 E BROAD ST STE A
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43205-1370
Country	:	US
Telephone Number	:	614-822-9055
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	HARSHIL MANIAR
Credential	:
Telephone Number	:	614-914-6611

Provider Enumeration Date	:	05/23/2019
Last Update Date	:	09/19/2023

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