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NPI Code Detail

MEDICARE: LAWSON'S BRIDGE HOME HEALTH CARE, LLC

MEDICARE: LAWSON'S BRIDGE 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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1912795592
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAWSON'S BRIDGE HOME HEALTH CARE, LLC
Provider Business Mailing Address
First Line : 3526 STELLHORN RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46815-8661
Country : US
Telephone Number : 260-298-7466
Fax Number : 260-298-7486
Provider Business Practice Location Address
First Line : 3526 STELLHORN RD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46815-8661
Country : US
Telephone Number : 260-298-7466
Fax Number : 260-298-7486
Authorized Official
Title or Position : CEO / OWNER
Name : SHIRLEY ANN MALONE
Credential :
Telephone Number : 260-298-7466
Provider Enumeration Date : 04/25/2025
Last Update Date : 04/25/2025

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