Provider Demographics
NPI:1720424492
Name:LIBERTY HOME HEALTH CARE OF OHIO, LLC
Entity type:Organization
Organization Name:LIBERTY HOME HEALTH CARE OF OHIO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:FARHIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIRWA
Authorized Official - Suffix:
Authorized Official - Credentials:01/13/2012
Authorized Official - Phone:614-825-9556
Mailing Address - Street 1:6161 BUSCH BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-2554
Mailing Address - Country:US
Mailing Address - Phone:614-825-9556
Mailing Address - Fax:614-825-9557
Practice Address - Street 1:6161 BUSCH BLVD STE 203
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-2554
Practice Address - Country:US
Practice Address - Phone:614-825-9556
Practice Address - Fax:614-825-9557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health