| Organization Name: | PROVIDER HOME CARE |
| NPI Number: | 1912313628 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PATRICIA RICHARDS (CNA) |
| Mailing Address: | 3832 Montevista Cleveland |
| State: | PROVINCE GE |
| Postal Code: | OHIO |
| Phone Number: | 2167991097 |
| Fax Number: | |
| NPI Enumeration Date: | 07/02/2014 |
| NPI Last Update Date: | 07/02/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 146N00000X |
| License Number: | FDW1871 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Emergency Medical Service Providers |
| Taxonomy Classification: | Emergency Medical Technician, Basic |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards. |