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
1	251E00000X	Home 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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