Provider Demographics
NPI:1669629325
Name:POPULAR SENIOR CARE
Entity Type:Organization
Organization Name:POPULAR SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FAISAL
Authorized Official - Middle Name:
Authorized Official - Last Name:ELMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-394-4375
Mailing Address - Street 1:1744 HUY RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-3550
Mailing Address - Country:US
Mailing Address - Phone:614-394-4375
Mailing Address - Fax:
Practice Address - Street 1:1744 HUY RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-3550
Practice Address - Country:US
Practice Address - Phone:614-394-4375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2535975Medicaid