MEDICARE: LIFELINE HOMECARE SERVICES, 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	2220866	OH

General Provider Information

NPI Number	:	1942637673
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFELINE HOMECARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	5979 E LIVINGSTON AVE STE 100
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-2908
Country	:	US
Telephone Number	:	614-751-8870
Fax Number	:	614-751-8876

Provider Business Practice Location Address
First Line	:	5979 E LIVINGSTON AVE
Second Line	:	SUITE 201
City	:	COLUMBUS
State	:	OH
Zip	:	43232-2908
Country	:	US
Telephone Number	:	614-751-8870
Fax Number	:	614-751-8876

Authorized Official
Title or Position	:	COO/ADMINISTRATOR
Name	:	MR. CHUKWUDI FRANKLIN ONYIA
Credential	:	LPN
Telephone Number	:	614-886-2195

Provider Enumeration Date	:	09/26/2013
Last Update Date	:	05/01/2024

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