1679562458 NPI number — PREFERRED HOME HEALTH CARE, INC.

Table of content: (NPI 1679562458)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679562458 NPI number — PREFERRED HOME HEALTH CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PREFERRED HOME HEALTH CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679562458
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/11/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 YARD ST STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRANDVIEW HEIGHTS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43212-3882
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-866-8158
Provider Business Mailing Address Fax Number:
614-866-8160

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6920 PARKDALE PLACE
Provider Second Line Business Practice Location Address:
STE 110
Provider Business Practice Location Address City Name:
INDIANAPOLIS
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46254-9558
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-245-7236
Provider Business Practice Location Address Fax Number:
317-245-7280
Provider Enumeration Date:
10/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ALBRECHT
Authorized Official First Name:
AARON
Authorized Official Middle Name:
SCOTT
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
419-631-8214

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 200231350A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 15D0678755 . This is a "CLIA LICENSE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".




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