Provider Demographics
NPI:1225803240
Name:AMERIALL HOME CARE LLC
Entity Type:Organization
Organization Name:AMERIALL HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ILKHOM
Authorized Official - Middle Name:
Authorized Official - Last Name:DURSUNOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-939-6785
Mailing Address - Street 1:9331 LAKESIDE ST
Mailing Address - Street 2:
Mailing Address - City:TIPP CITY
Mailing Address - State:OH
Mailing Address - Zip Code:45371-2590
Mailing Address - Country:US
Mailing Address - Phone:215-939-6785
Mailing Address - Fax:
Practice Address - Street 1:9331 LAKESIDE ST
Practice Address - Street 2:
Practice Address - City:TIPP CITY
Practice Address - State:OH
Practice Address - Zip Code:45371-2590
Practice Address - Country:US
Practice Address - Phone:215-939-6785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-20
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care