Provider Demographics
NPI:1093343766
Name:MIDWEST HOME CARE SERVICES, LLC
Entity Type:Organization
Organization Name:MIDWEST HOME CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABDIAZIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:WARSAME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-496-6390
Mailing Address - Street 1:2570 OAKSTONE DR STE 7
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-8619
Mailing Address - Country:US
Mailing Address - Phone:614-423-7478
Mailing Address - Fax:614-423-7468
Practice Address - Street 1:2570 OAKSTONE DR STE 7
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-8619
Practice Address - Country:US
Practice Address - Phone:614-423-7478
Practice Address - Fax:614-423-7468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-30
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
2570954OtherDODD CONTRACT NUMBER
OH0185439Medicaid