Provider Demographics
NPI:1841546926
Name:FIDELITY HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:FIDELITY HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:TOUMGUE
Authorized Official - Last Name:ANUH-NDUMU
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN
Authorized Official - Phone:402-301-8731
Mailing Address - Street 1:6650 S 84TH AVE STE 100A
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-4105
Mailing Address - Country:US
Mailing Address - Phone:402-884-9581
Mailing Address - Fax:402-763-9126
Practice Address - Street 1:6650 S 84TH AVE STE 100A
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127
Practice Address - Country:US
Practice Address - Phone:402-884-9581
Practice Address - Fax:402-763-9126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
NE251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health