Provider Demographics
NPI:1982302741
Name:MOHAMED, ABUBAKAR ABDI SR (CEO)
Entity Type:Individual
Prefix:
First Name:ABUBAKAR
Middle Name:ABDI
Last Name:MOHAMED
Suffix:SR
Gender:M
Credentials:CEO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 BRYDEN RD STE 154
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-4839
Mailing Address - Country:US
Mailing Address - Phone:614-805-7328
Mailing Address - Fax:
Practice Address - Street 1:700 BRYDEN RD STE 154
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-4839
Practice Address - Country:US
Practice Address - Phone:614-805-7328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health