Provider Demographics
NPI:1255667788
Name:PROFESSIONAL HOME HEALTH CARE SERVICES LLC
Entity Type:Organization
Organization Name:PROFESSIONAL HOME HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALIDAHIR
Authorized Official - Middle Name:Y
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-360-1944
Mailing Address - Street 1:5918 SHARON WOODS BLVD STE 170
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-2671
Mailing Address - Country:US
Mailing Address - Phone:614-360-1944
Mailing Address - Fax:614-898-7775
Practice Address - Street 1:5918 SHARON WOODS BLVD STE 170
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-2671
Practice Address - Country:US
Practice Address - Phone:614-360-1944
Practice Address - Fax:614-898-7775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-17
Last Update Date:2009-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health