Organization
PHYSIOCARE HOME HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK STOTZ (CEO)
(917) 882-8513
Entity
Organization
Contact information
Practice address
1440 INNOVATION PL, WEST LAFAYETTE, IN 47906-1000
(765) 838-1660
(765) 838-1662
Mailing address
1440 INNOVATION PL, WEST LAFAYETTE, IN 47906-1000
(765) 838-1660
(765) 838-1662
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
11-012233
IN
251E00000X
Home Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15K055
—
IN
Enumeration date
10/28/2009
Last updated
04/24/2026
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