MEDICARE: OASIS PERSONAL CARE PROVIDERS 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	:	1972193126
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OASIS PERSONAL CARE PROVIDERS LLC

Provider Business Mailing Address
First Line	:	1642 S PARKER RD STE 106
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-2918
Country	:	US
Telephone Number	:	303-696-2424
Fax Number	:	303-474-3957

Provider Business Practice Location Address
First Line	:	1642 S PARKER RD STE 106
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-2918
Country	:	US
Telephone Number	:	303-696-2424
Fax Number	:	303-474-3957

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. BINYAM AYNALEM
Credential	:
Telephone Number	:	303-696-2424

Provider Enumeration Date	:	01/21/2021
Last Update Date	:	01/21/2021

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