Provider Demographics
NPI:1518773969
Name:BEDROCK HOME HEALTHCARE
Entity type:Organization
Organization Name:BEDROCK HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ISSACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-586-5970
Mailing Address - Street 1:9701 BROOKPARK RD STE 10
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-6824
Mailing Address - Country:US
Mailing Address - Phone:216-712-4160
Mailing Address - Fax:888-607-9054
Practice Address - Street 1:9701 BROOKPARK RD STE 10
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-6824
Practice Address - Country:US
Practice Address - Phone:216-712-4160
Practice Address - Fax:888-607-9054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health