Provider Demographics
NPI:1013058528
Name:MEDICOM HEALTH CARE, LLC
Entity Type:Organization
Organization Name:MEDICOM HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMKHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-476-6413
Mailing Address - Street 1:465 WATERBURY CT
Mailing Address - Street 2:STE. C
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-5312
Mailing Address - Country:US
Mailing Address - Phone:614-476-6413
Mailing Address - Fax:614-476-6423
Practice Address - Street 1:465 WATERBURY CT
Practice Address - Street 2:STE. C
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-5312
Practice Address - Country:US
Practice Address - Phone:614-476-6413
Practice Address - Fax:614-476-6423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health