MEDICARE: ASHTABULA REGIONAL HOME HEALTH SERVICES

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	NA	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972507200
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASHTABULA REGIONAL HOME HEALTH SERVICES

Provider Business Mailing Address
First Line	:	PO BOX 1428
Second Line	:
City	:	ASHTABULA
State	:	OH
Zip	:	44005-1428
Country	:	US
Telephone Number	:	440-992-4663
Fax Number	:	440-992-0687

Provider Business Practice Location Address
First Line	:	2131 LAKE AVE STE 2
Second Line	:
City	:	ASHTABULA
State	:	OH
Zip	:	44004-3466
Country	:	US
Telephone Number	:	440-992-4663
Fax Number	:	440-992-0687

Authorized Official
Title or Position	:	ACCOUNTS SUPERVISOR
Name	:	CONNIE FOX
Credential	:
Telephone Number	:	440-997-6257

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	01/08/2019

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