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NPI Code Detail

MEDICARE: MEDIVITA HOMECARE LLC

MEDICARE: MEDIVITA HOMECARE 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 : 1922957190
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDIVITA HOMECARE LLC
Provider Business Mailing Address
First Line : 6690 FOUNTAINS BLVD APT I203
Second Line :
City : WEST CHESTER
State : OH
Zip : 45069-2149
Country : US
Telephone Number : 513-663-1435
Fax Number :
Provider Business Practice Location Address
First Line : 6690 FOUNTAINS BLVD APT I203
Second Line :
City : WEST CHESTER
State : OH
Zip : 45069-2149
Country : US
Telephone Number : 513-663-1435
Fax Number :
Authorized Official
Title or Position : OWNER
Name : CLARA NECRUTU
Credential :
Telephone Number : 513-663-1435
Provider Enumeration Date : 01/22/2026
Last Update Date : 01/27/2026

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