Provider Demographics
NPI:1669737128
Name:MERCY HOME HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:MERCY HOME HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:MR
Authorized Official - First Name:INDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAJAGAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-484-4789
Mailing Address - Street 1:6430 EAST MAIN ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068
Mailing Address - Country:US
Mailing Address - Phone:614-484-4789
Mailing Address - Fax:614-762-3804
Practice Address - Street 1:6430 EAST MAIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068
Practice Address - Country:US
Practice Address - Phone:614-762-6213
Practice Address - Fax:614-762-3804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-11
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHDCN 12199C24100884OtherPALMETTO GBA DCN NUMBER