Provider Demographics
NPI:1588717615
Name:VANGUARD HOME HEALTH CARE INC
Entity type:Organization
Organization Name:VANGUARD HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDIKARIM
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:OMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-414-7375
Mailing Address - Street 1:3314 MORSE RD STE 208
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-6100
Mailing Address - Country:US
Mailing Address - Phone:614-376-9161
Mailing Address - Fax:614-342-2615
Practice Address - Street 1:3314 MORSE RD STE 208
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-6100
Practice Address - Country:US
Practice Address - Phone:614-376-9161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-20
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHNONEMedicare ID - Type UnspecifiedHOME HEALTH CARE