MEDICARE: EMANCICARE HOME HEALTH 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	282760064	OTHER	OH	PASSPORT
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972816882
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMANCICARE HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	4889 SINCLAIR RD
Second Line	:	SUITE 105
City	:	COLUMBUS
State	:	OH
Zip	:	43229-5432
Country	:	US
Telephone Number	:	614-547-0282
Fax Number	:	614-547-0284

Provider Business Practice Location Address
First Line	:	4889 SINCLAIR RD
Second Line	:	SUITE 105
City	:	COLUMBUS
State	:	OH
Zip	:	43229-5432
Country	:	US
Telephone Number	:	614-547-0282
Fax Number	:	614-547-0284

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MR. ROBERT W. VANSICKLE III
Credential	:
Telephone Number	:	614-547-0282

Provider Enumeration Date	:	07/20/2010
Last Update Date	:	10/30/2013

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Directions to “EMANCICARE HOME HEALTH LLC ” Practice Location

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