Provider Demographics
NPI:1902178502
Name:AG HOME HEALTH CARE
Entity Type:Organization
Organization Name:AG HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EARL
Authorized Official - Middle Name:M
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-544-4581
Mailing Address - Street 1:4536 WILBURN DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3863
Mailing Address - Country:US
Mailing Address - Phone:216-544-4581
Mailing Address - Fax:
Practice Address - Street 1:12713 BUCKEYE RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44120-2655
Practice Address - Country:US
Practice Address - Phone:216-544-4581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health