Provider Demographics
NPI:1588846737
Name:INDEPENDENT HOME HEALTH INC
Entity Type:Organization
Organization Name:INDEPENDENT HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LEONID
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUPOVLYANSKIY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-915-0392
Mailing Address - Street 1:6012 MAYFIELD RD
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-3205
Mailing Address - Country:US
Mailing Address - Phone:440-442-3600
Mailing Address - Fax:440-442-3602
Practice Address - Street 1:6012 MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-3205
Practice Address - Country:US
Practice Address - Phone:440-442-3600
Practice Address - Fax:440-442-3602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH368394Medicare PIN