Provider Demographics
NPI:1356986400
Name:QUEEN HOME HEALTH AGENCY LLC
Entity type:Organization
Organization Name:QUEEN HOME HEALTH AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:RAFAL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAZOOKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-947-0050
Mailing Address - Street 1:1505 BETHEL RD STE 201
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-2055
Mailing Address - Country:US
Mailing Address - Phone:614-947-0050
Mailing Address - Fax:614-947-0337
Practice Address - Street 1:5890 SAWMILL RD STE 220
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-7568
Practice Address - Country:US
Practice Address - Phone:614-947-0050
Practice Address - Fax:614-947-0337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-13
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health