Provider Demographics
NPI:1922109966
Name:MEDEX HOME HEALTHCARE INCORPORATED
Entity Type:Organization
Organization Name:MEDEX HOME HEALTHCARE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:KWASI
Authorized Official - Last Name:HODOGBEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-488-1400
Mailing Address - Street 1:8124 S COTTAGE GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60619-5104
Mailing Address - Country:US
Mailing Address - Phone:773-488-1400
Mailing Address - Fax:
Practice Address - Street 1:8124 S COTTAGE GROVE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60619-5104
Practice Address - Country:US
Practice Address - Phone:773-488-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health