Provider Demographics
NPI:1891517686
Name:OLENTANGY HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:OLENTANGY HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:JAMA
Authorized Official - Last Name:ASHOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-707-2310
Mailing Address - Street 1:6161 BUSCH BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-2590
Mailing Address - Country:US
Mailing Address - Phone:614-707-2310
Mailing Address - Fax:
Practice Address - Street 1:6161 BUSCH BLVD STE 108
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-2590
Practice Address - Country:US
Practice Address - Phone:614-707-2310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health