Provider Demographics
NPI:1699067330
Name:ANDREW HOME HEALTHCARE SERVICES, LLC
Entity type:Organization
Organization Name:ANDREW HOME HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:BLAMO
Authorized Official - Last Name:NIMELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-439-1930
Mailing Address - Street 1:5330 E MAIN ST STE 103
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:OH
Mailing Address - Zip Code:43213-2571
Mailing Address - Country:US
Mailing Address - Phone:614-864-1700
Mailing Address - Fax:614-347-1790
Practice Address - Street 1:5330 E MAIN ST STE 103
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:OH
Practice Address - Zip Code:43213-2571
Practice Address - Country:US
Practice Address - Phone:614-864-1700
Practice Address - Fax:614-347-1790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-13
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3077058Medicaid